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Non-alcoholic fatty liver disease (NAFLD) is currently related to a heavy socioeconomic burden and increased incidence. Since obesity is the most prevalent risk factor for NAFLD, weight loss is an effective therapeutic solution. Bariatric surgery (BS), which can achieve long-term weight loss, improves the overall health of patients with NAFLD. The two most common surgeries are the Roux-en-Y gastric bypass and sleeve gastrectomy. The gut-liver axis is the complex network of cross-talking between the gut, its microbiome, and the liver. The gut microbiome, involved in the homeostasis of the gut-liver axis, is believed to play a significant role in the pathogenesis of NAFLD and the metabolic improvement after BS. Alterations in the gut microbiome in NAFLD have been confirmed compared to that in healthy individuals. The mechanisms linking the gut microbiome to NAFLD have been proposed, including increased intestinal permeability, higher energy intake, and other pathophysiological alterations. Interestingly, several correlation studies suggested that the gut microbial signatures after BS become more similar to those of lean, healthy controls than that of patients with NAFLD. The resolution of NAFLD after BS is related to changes in the gut microbiome and its metabolites. However, confirming a causal link remains challenging. This review summarizes characteristics of the gut microbiome in patients with NAFLD before and after BS and accumulates existing evidence about the underlying mechanisms of the gut microbiome. [ABSTRACT FROM AUTHOR]

Objective: The current study aimed to (a) describe moderate-to-vigorous physical activity (MVPA), sedentary behavior (SB), and cardiorespiratory fitness (VO2Peak) via objective assessment among adolescents with congenital heart disease (CHD), (b) examine gender differences on MVPA, SB, VO2Peak, and the Theory of Planned Behavior elements, and (c) identify whether gender moderates the relationships between the Theory of Planned Behavior elements and MVPA, SB, and VO2Peak.Methods: Adolescent CHD survivors (N = 86; ages 15-18 years) wore an accelerometer to assess MVPA and SB, underwent an exercise stress test to assess VO2Peak, and completed a survey of the Theory of Planned Behavior elements as measured by perceived benefits (attitudes), family/friend support and perceived norms (social norms), and self-efficacy and barriers (perceived behavioral control) to engaging in physical activity.Results: On average, CHD survivors engaged in 22.3 min (SD = 15.3) of MVPA/day and 9 hr of SB/day (M = 565.8, SD = 102.5 min). Females engaged in less MVPA but not more SB had a lower mean VO2Peak, reported lower self-efficacy, and perceived greater barriers than males. In a regression model, barriers explained unique variance in MVPA and VO2Peak, but the relationship between barriers and MVPA/VO2Peak did not vary by gender. Self-efficacy did not explain unique variance in MVPA and VO2Peak when included in a model with gender and barriers.Conclusions: Family/friend support for physical activity engagement may be an important consideration when developing physical activity interventions for adolescent CHD survivors. The role of gender differences in self-efficacy and perceived barriers on physical activity engagement warrants further investigation. [ABSTRACT FROM AUTHOR]

Aerobics formation is a type of sport that can be performed for long periods with the aid of music. Traditional aerobic sports have influenced the development of the competitive aerobics training service project, which has racing as one of its primary goals. Transformation of aerobics training uses seven fundamental steps, diverse dynamics, and complete execution of challenging exercises to display the competitive athletics abilities of health, strength, and beauty. The challenging characteristics of aerobics formation transformation route simulation include aerobic fitness level from the beginning, the intensity of training, frequency of coaching, condition of heart disease, blood pressure, high distance running, and increasing repeated exercise, which can develop significant problems. This paper introduces an advanced artificial intelligence (AI) assisted by big data algorithm (BD) for the simulation of aerobics formation (AF) to enhance overall fitness; cardio is a sort of activity that involves physical endurance with flexibility and muscle toning. The research of AIBD-AF has many advantages like reducing the danger to your health and strengthening the heart's muscular fibers with stamina. It is good for cardiovascular arteries since it removes clogs. The immune system is expanded, and aids in better managing long-term ailments and also keeps the body fit as you get older and weaker. In addition to improving fitness levels, aerobics also helps to teach the heart and lungs to carry oxygen to the entire body more effectively. [ABSTRACT FROM AUTHOR]

Ankylosing spondylitis (AS) is a chronic inflammatory disease that causes spinal inflammation and fusion. Although the cause of AS is unknown, genetic factors (e.g., HLA-B27) and environmental factors (e.g., sex, age, and infection) increase the risk of AS. Current treatments for AS are to improve symptoms and suppress disease progression. There is no way to completely cure it. High blood cholesterol and lipid levels aggravate the symptoms of autoimmune diseases. We applied hyperlipidemia drugs ezetimibe and rosuvastatin to AS mice and to PBMCs from AS patients. Ezetimibe and rosuvastatin was administered for 11 weeks to AS model mice on the SKG background. Then, the tissues and cells of mice were performed using flow cytometry, computed tomography, immunohistochemistry, and immunofluorescence. Also, the normal mouse splenocytes were cultured in Th17 differentiation conditions for in vitro analysis such as flow cytometry, ELISA and RNA sequencing. The 10 AS patients' PBMCs were treated with ezetimibe and rosuvastatin. The patients' PBMC were analyzed by flow cytometry and ELISA for investigation of immune cell type modification. Ezetimibe caused substantial inhibition for AS. The present study showed that ezetimibe inhibits Th17 cell function, thereby slowing the progression of AS. It is well known that statins are more effective in reducing blood lipid concentrations than ezetimibe, however, our results that ezetimibe had a better anti-inflammatory effect than rosuvastatin in AS. This data suggests that ezetimibe has an independent anti-inflammatory effect independent of blood lipid reduction. To investigate whether ezetimibe has its anti-inflammatory effect through which signaling pathway, various in vitro experiments and RNA sequencing have proceeded. Here, this study suggests that ezetimibe can be an effective treatment for AS patients by inhibiting Th17 differentiation-related genes such as IL-23R and IL-1R. Thus, this study suggests that ezetimibe has therapeutic potential for AS through inhibition of Th17 differentiation and the production of pro-inflammatory cytokines. [ABSTRACT FROM AUTHOR]

Background: In the context of the ageing of the French population, physical activity becomes a principal means for maintaining good health. International organisations are thus giving increasing importance to physical activity in programmes of disease-prevention. In parallel with these concerns, studies have shown the impact of sedentary activities (in particularly as a result of the seated position and screen time) on health. Objective: To show the links between physical activity, sedentarism and health indicators and to identify the socio-demographic variables by which they are influenced (particularly gender). Study design: This is a transversal epidemiological study conducted among the French population between 2014 and 2016 by Santé publique France, the national public health agency. Methods: The RPAQ (Recent Physical Activity Questionnaire) was used to measure the physical activity and sedentary lifestyle of individuals. The analyses focus on the behaviours among the population of older adults (55–74 years old, n = 1155). Results: A third of French older adults does not meet the WHO recommended physical activity levels, particularly so among women. The results of this survey point to significant links between health indicators (especially overweight and obesity) and the physical activity level and sedentarity of older adults. From the age of 60, energy expenditure linked to physical activity increases before decreasing from the age of 65. Older adults spend almost 6 hours per day in sedentary activities. The combinations between physical activity and sedentarism highlight four profiles of older adults. The most active profile is the one with the best health indicators. Conclusion: The links between health, sedentarity and physical activity are unequivocal: people who achieve the WHO recommendations for physical activity and spend less than 7 hours each day in sedentary activities are those who also have the best health indicators. These results vary with sociographic characteristics and reveal significant links with health indicators. [ABSTRACT FROM AUTHOR]

Dihuang Yinzi, as a classical Chinese medicine prescription, plays an important role for the treatment of ischemic stroke. Gut microbiota play a functional role for the expression of proinflammatory cytokines and anti-inflammatory cytokines, which further affect central nervous system and change brain function. Our research confirmed that Dihuang Yinzi can exert brain protection by inhibiting inflammatory reaction. Dihuang Yinzi can significantly decrease the contents of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and interleukin-17 (IL-17) in brain, serum, and colon tissues and increase the contents of transforming growth factor-β (TGF-β) and interleukin-10 (IL-10) in cerebral ischemia-reperfusion model rats. The results of 16s rRNA high-throughput sequencing showed that Dihuang Yinzi had a significant effect on microbiome in rats. The firmicutes, bacteroidetes, and proteobacteria were dominant in Dihuang Yinzi group. The content of firmicutes increased with the increase of dosage of Dihuang Yinzi. Especially, the content of actinomycetes in the high-dose group was higher than other groups. At the genus level, the number of bacteroides in the antibiotic groups was significantly higher than that in the other treatment groups. The results suggest that Dihuang Yinzi may play important roles in treatment of ischemic stroke by regulating the gut microbiota and the inflammatory reaction in the colon tissues, serum, and brain of the model rats, to verify the scientific nature of this prescription in relieving brain inflammatory reaction and brain injury by this way and to reveal the brain-gut related mechanism of Dihuang Yinzi in treating ischemic stroke. [ABSTRACT FROM AUTHOR]

Age-related chronic diseases are among the most common causes of mortality and account for a majority of global disease burden. Preventative lifestyle behaviors, such as regular exercise, play a critical role in attenuating chronic disease burden. However, the exact mechanism behind exercise as a form of preventative medicine remains poorly defined. Interestingly, many of the physiological responses to exercise are comparable to aging. This paper explores an overarching hypothesis that exercise protects against aging/age-related chronic disease because the physiological stress of exercise mimics aging. Acute exercise transiently disrupts cardiovascular, musculoskeletal, and brain function and triggers a substantial inflammatory response in a manner that mimics aging/age-related chronic disease. Data indicate that select acute exercise responses may be similar in magnitude to changes seen with +10-50 years of aging. The initial insult of the agemimicking effects of exercise induces beneficial adaptations that serve to attenuate disruption to successive "aging" stimuli (i.e., exercise). Ultimately, these exerciseinduced adaptations reduce the subsequent physiological stress incurred from aging and protect against age-related chronic disease. To further examine this hypothesis, future work should more intricately describe the physiological signature of different types/intensities of acute exercise in order to better predict the subsequent adaptation and chronic disease prevention with exercise training in healthy and at-risk populations. [ABSTRACT FROM AUTHOR]

The objective was to determine the contributions to changes in moderate-to-vigorous physical activity (MVPA) during the COVID-19 restrictions by age, gender, education, place of residence, type of work, type of sport, Body Mass Index (BMI), subjective health status, smoking, alcohol consumption, overeating, impulsivity, depression symptoms, stress level, sleep duration and emotional intelligence (EI). We interviewed 6369 people in Lithuania before the COVID-19 pandemic and 2392 during the COVID-19 restrictions, and they were 18–4 years old. The initial COVID-19 restrictions reduced MVPA. This decrease was greater in individuals with lower education levels, higher BMI, higher stress levels and higher self-rated health status. MVPA decreased among those whose self-rated health status was the poorest but increased among those whose self-rated health status was the best. MVPA decreased among young women, women whose work was mostly sedentary and smoking women, and it decreased among overeating men. The particularity of sport, alcohol consumption, sleep duration, EI, impulsivity and depression symptoms did not have a significant effect on changes in MVPA during the COVID-19 restrictions, among either gender or any age group. [ABSTRACT FROM AUTHOR]

Background: The prevalence of sedentary behavior in adolescents has aroused social attention. The association between sedentary behavior and cognitive flexibility remains unclear, and it may vary depending on the type of sedentary behavior. This study aimed to investigate the associations between specific-type sedentary behaviors and cognitive flexibility in adolescents. Method: A total of 700 Chinese adolescents aged 10-15 years were recruited. The self-report questionnaire was used to assess total sedentary time, recreational screen-based sedentary time, and educational sedentary time. The More-odd shifting task was used to assess cognitive flexibility. Results: The correlation analysis showed that recreational screen-based sedentary time was negatively correlated with cognitive flexibility, whereas educational sedentary time was positively correlated with cognitive flexibility. The regression analysis also further revealed that a significantly negative association between recreational screen-based sedentary time and cognitive flexibility, while a significantly positive association existed between educational sedentary time and cognitive flexibility. Conclusion: The findings shown that the association between recreational screen-based sedentary behavior and cognitive flexibility differs from educational sedentary behavior in adolescents, providing new ideas for a more comprehensive understanding of the association between sedentary behavior and cognitive flexibility in adolescents. [ABSTRACT FROM AUTHOR]

Obstructive sleep apnea (OSA) is one of the most common and serious sleep-related breathing disorders with a high prevalence among patients with cardiovascular (CV) diseases. Despite its widespread presence, OSA remains severely undiagnosed and untreated. CV mortality and morbidity are significantly increased in the presence of OSA as it is associated with an increased risk of resistant hypertension, heart failure, arrhythmias, and coronary artery disease. Evaluation and treatment of OSA should focus on recognizing patients at risk of developing OSA. The use of screening questionnaires should be routine, but a formal polysomnography sleep study is fundamental in establishing and classifying OSA. Recognition of OSA patients will allow for the institution of appropriate therapy that should alleviate OSA-related symptoms with the intent of decreasing adverse CV risk. In this review, we focus on the impact OSA has on CV disease and evaluate contemporary OSA treatments. Our goal is to heighten awareness among CV practitioners. [ABSTRACT FROM AUTHOR]

A ubiquitous aspect of contemporary societies is sedentary behavior (SB), defined as low intensity activities in a seated, reclined, or supine posture. Leading public health agencies, including the World Health Organization, have recognized the strong association between SB and poor health outcomes, particularly cardiovascular disease. However, while public health agencies have begun to advocate for "reductions" in SB, the current US guidelines are typically vague and non-specific. There is good reasoning behind this non-committal advocacy--there is limited mechanistic and clinical evidence to support policy development. To guide SB policy development, it is important to first consider the origins and evolution of SB, including the following: 1) is SB really a novel/contemporary behavior? i.e., how has this behavior evolved? 2) how did our ancestors sit and in what contexts? 3) how does SB interact with 24-hour activity behaviors, including physical activity and sleep? 4) what other historical and contemporary facets of life interact with SB? and 5) in what context do these behaviors occur and how might they provide different evolutionarily novel stressors? This perspective article will synthesize the available evidence that addresses these questions and stimulate discussion pertaining to the lessons that we can learn from an historical and evolutionary perspective. Last, it will outline the gaps in current SB interruption literature that are hindering development of feasible SB reduction policy. [ABSTRACT FROM AUTHOR]

An interaction between mitochondrial dynamics, physical activity levels, and COVID‐19 severity has been previously hypothesized. However, this has not been tested. We aimed to compare mitochondrial morphology and cristae density of PBMCs between subjects with non‐severe COVID‐19, subjects with severe COVID‐19, and healthy controls. Additionally, we compared the level of moderate‐vigorous physical activity (MVPA) and sitting time between groups. Blood samples were taken to obtain PBMCs. Mitochondrial dynamics were assessed by electron microscopy images and western blot of protein that regulate mitochondrial dynamics. The International Physical Activity Questionnaire (IPAQ; short version) was used to estimate the level of MVPA and the sitting time The patients who develop severe COVID‐19 (COVID‐19++) not present alterations of mitochondrial size neither mitochondrial density in comparison to non‐severe patients COVID‐19 (COVID‐19) and control subjects (CTRL). However, compared to CTRL, COVID‐19 and COVID‐19++ groups have lower mitochondrial cristae length, a higher proportion of abnormal mitochondrial cristae. The COVID‐19++ group has lower number (trend) and length of mitochondrial cristae in comparison to COVID‐19 group. COVID‐19, but not COVID‐19++ group had lower Opa 1, Mfn 2 and SDHB (Complex II) proteins than CTRL group. Besides, COVID‐19++ group has a higher time sitting. Our results show that low mitochondrial cristae density, potentially due to physical inactivity, is associated with COVID‐19 severity. [ABSTRACT FROM AUTHOR]

Introduction: Rare diseases (RDs) are a severe, chronic, degenerative and often life-threatening group of conditions affecting more than 30 million people in Europe. Their impact is often underreported and ranges from psychological and physical symptoms seriously compromising quality of life. There is then a need to consolidate knowledge on the economic, social, and quality of life impacts of rare diseases. Methods: This scoping review is the result of 9 qualitative interviews with experts and a literature search on Cost-of-Illness (COI) studies and quality of life (QoL) studies following the PRISMA methodology. Grey literature was also included to complement findings. Results. 63 COI studies were retrieved, covering 42 diseases and a vast majority of them using a prevalence-based approach (94%). All studies included medical costs, while 60% included non-medical costs, 68% productivity losses and 43% informal care costs. 56 studies on QoL were retrieved, mostly from Europe, with 30 different measurement tools. Grey literature included surveys from the pharmaceutical industry and patient organisations. Discussion: The majority of studies evaluating the impact of RDs on the individual and society use the COI approach, mostly from a societal perspective. Studies often vary in scope, making them difficult to consolidate or compare results. While medical costs and productivity losses are consistently included, QoL aspects are rarely considered in COI and are usually measured through generic tools. Conclusion: A comprehensive study on impact of rare disease across countries in Europe is lacking. Existing studies are heterogeneous in their scope and methodology and often lack a holistic picture of the impact of rare. Consensus on standards and methodology across countries and diseases is then needed. Studies that consider a holistic approach are often conducted by pharmaceutical companies and patient organisations exploring a specific disease area but are not necessarily visible in the literature and could benefit from the sharing of standards and best practices. [ABSTRACT FROM AUTHOR]

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Physical activity (PA) is globally recognized as a pillar of general health. Step count, as one measure of PA, is a well known predictor of long-term morbidity and mortality. Despite its popularity in consumer devices, a lack of methodological standards and clinical validation remains a major impediment to step count being accepted as a valid clinical endpoint. Previous works have mainly focused on device-specific step-count algorithms and often employ sensor modalities that may not be widely available. This may limit step-count suitability in clinical scenarios. In this paper, we trained neural network models on publicly available data and tested on an independent cohort using two approaches: generalization and personalization. Specifically, we trained neural networks on accelerometer signals from one device and either directly applied them or adapted them individually to accelerometer data obtained from a separate subject cohort wearing multiple distinct devices. The best models exhibited highly accurate step-count estimates for both the generalization (96–99%) and personalization (98–99%) approaches. The results demonstrate that it is possible to develop device-agnostic, accelerometer-only algorithms that provide highly accurate step counts, positioning step count as a reliable mobility endpoint and a strong candidate for clinical validation. [ABSTRACT FROM AUTHOR]

In the context of high-throughput data, the differences in continuous markers between two groups are usually assessed by ordering the p-values obtained from the two-sample pooled t-test or Wilcoxon-Mann-Whitney test and choosing a stringent cutoff such as 10-8 to control the family-wise error rate (FWER) or false discovery rate (FDR). All markers with p-values below the cutoff are declared to be significantly associated with the phenotype. This inherently assumes that the test procedure provides valid type I error estimates in extreme tails of the null distribution. The aforementioned tests assume homoscedasticity in the two groups, and the t-test further assumes underlying distributions to be normally distributed. Cao et al. (Biometrika, 2013, 100, 495-502) have shown that in the context of multiple hypotheses testing the approach based on FDR may not be valid under non-normality and/or heteroscedasticity. Therefore, having a test statistic that is robust to these violations is needed. In this study, we propose a robust analog of Behrens-Fisher statistic based on trimmed means, conduct an extensive simulation study to compare its performance with other competing approaches, and demonstrate its usefulness by applying it to DNA methylation data used by Teschendorff et al. (Genome Res., 2010, 20, 440-446). An R program to implement the proposed method is provided in the Supplementary Material. [ABSTRACT FROM AUTHOR]

The conservation benefits of marine reserves are well established but their contribution to adjacent fisheries via spillover is less certain and context‐dependent. Theoretical predictions do not always match empirical evidence from individual reserves, so carefully designed studies are essential for accurately assessing spillover and its contribution to fisheries. Biomass buildup within reserves, and spillover from reserve borders, also usually takes time to develop. In 2003, a network of no‐take marine reserves was established in the Northern Channel Islands (NCI) of southern California (CA) to conserve biodiversity and to eventually enhance local fisheries through spillover of larvae, juveniles, and adults. The reserve network impacted the local CA spiny lobster (Panulirus interruptus) fishery by removing about 20% of fishing grounds in the NCI. In 2008, a collaborative fisheries research effort detected substantial lobster population increases within reserves, and an indication of the possible spillover of adult lobsters across reserve borders. To estimate whether and how much populations within reserves, and spillover from reserves, have increased through time, we repeated the sampling program 10 years later in 2018 at two of the three original reserves. Scientific trapping was conducted prior to the fishing season along a spatial gradient beginning deep within the reserves to reference sites located outside (≥2 km) of reserve borders. Results showed that legal‐sized lobster abundance in traps (catch per unit effort) increased by 125%–465% deep inside reserves, and by 223%–331% at sites near to reserve borders, and by nearly 400% just outside of reserve borders over the 10‐year period, thus indicating a substantial increase in spillover across reserve borders. A similar pattern was observed in lobster biomass caught in traps at the two reserves. This study demonstrates how spillover scales with biomass buildup and that collaborative fisheries research can be used to assess the efficacy of marine reserves as fishery management tools worldwide. [ABSTRACT FROM AUTHOR]

Background: Physical activity health benefits are widely known. However, the association between physical activity, physical fitness, executive function, and academic performance need further investigation. Additionally, one of the literature gaps reveals scarce and mixed findings on what mediators of physical activity may affect academic achievement. Purpose: This investigation aims to provide knowledge about the mediation role of physical fitness and executive function in the association of physical activity with academic achievement in a cohort of Spanish schoolchildren using a structural equation modelling approach. Methods: The data for this cross-sectional study were collected from a convenience sample of children from Spain (Balearic Islands) aged between 9 and 13 years. Physical activity levels were self-reported with the Physical Activity Questionnaire for Children; physical fitness was assessed using the International Fitness Scale; executive function was assessed with the Trail Making Test, and children's achievements were collected from the school records. Structural equation modelling was used to explore the relationship between physical activity, physical fitness, executive function, and academic achievement. Findings: Statistically significant positive direct associations were observed between physical activity and physical fitness (β = 0.46, 95% CI [0.29, 0.64]), physical fitness and executive function (β = 0.28, 95% CI [0.04, 0.52]), and executive function and academic achievement (β = 0.46, 95% CI [0.28, 0.65]), while adjusting for the confounding effects of sex and body mass index. Furthermore, indirect associations were observed between physical activity and executive function mediated by physical fitness (β = 0.13, bias-corrected 95% CI [0.02, 0.31]) and between physical fitness and academic achievement through executive function (β = 0.13, bias-corrected 95% CI [0.03, 0.32]). Conclusions: This investigation adds to the literature with evidence supporting the idea that regular PA leads to improvements in physical fitness and may support cognitive skills and academic performance in children. [ABSTRACT FROM AUTHOR]

Background: Both reducing sitting and increasing physical exercise promote health but exercising more does not necessarily reduce sitting time. One reason for this non-dependency may be that different aspects of exercise motivation are differently related to sitting time. Identifying the type of exercise motivation that would also be associated with sitting time can help to reduce sitting indirectly through increased exercise, thus bringing greater benefits. Methods: The present study explored the association between quality of motivations toward physical activity with physical activity and sitting time in a total of 373 adults (age range = 23–81; women n = 256). The short version of international physical activity questionnaire (IPAQ) was used for measuring physical activity and sitting time. Reasons for exercising regularly were measured with the Self-Regulated Questionnaire–Exercise (SRQ-E), including four regulation subscales to assess regulation styles (i.e., intrinsic motivation, identified regulation, introjected regulation and external regulation). Confirmatory factor analysis (CFA) was used to test the four subscales of SRQ-E (latent variables) with the data obtained using AMOS v.23 (Analysis of Moment Structures). Then, structural equation model (SEM) with maximum likelihood estimates was used to test the hypothesized model. Results: The results indicated that only intrinsic motivation, but not identified, introjected or external motivation, toward physical activity predicted both physical activity and sitting time. Higher intrinsic motivation toward physical activity was associated with both higher physical activity and lower sitting time. In addition, physical activity was a mediator for lower sitting time when the source was intrinsic motivation. Conclusion: Previous studies have shown low between and within participant correlation between sitting time and physical activity, and interventions have generally failed to both increase physical activity while decreasing sitting time. The present cross-sectional results suggest that targeting increased physical activity by increased intrinsic motivation has the potential to both increase physical activity and decrease sitting time. [ABSTRACT FROM AUTHOR]

One promising though understudied approach to addressing race/ethnic disparities in teen pregnancy rates is through sexual and reproductive health (SRH) programming for young men. This pilot study assessed the feasibility, quality, and preliminary efficacy of Manhood 2.0—a group-based, after-school SRH program for young Black and Latino men, which examines gender norms. This mixed-methods study describes program attendance and quality; participant experiences and engagement in the program; and changes in participant gender norms, knowledge, attitudes, self-efficacy, and social support. Quantitative data from baseline and post-intervention surveys (n = 51) were analyzed using paired t -tests and McNemar's tests. Qualitative data from five post-intervention focus groups (n = 27) were transcribed, coded, and analyzed for themes. At baseline, participants were ages 15 to18 years (M = 16.4 years), 30% were Latino, 66% were Black, 34% ever had sex, and 44% of sexually active participants had sex without any contraceptive method or condom. Quality ratings by program observers were high. The majority of participants (61%) attended at least 75% of sessions, and 96% rated Manhood 2.0 as "very good" or "excellent." Pre–post comparisons showed increases in receipt of SRH information; contraception knowledge; positive attitudes about supporting partners in pregnancy prevention; self-efficacy in partner communication about sex; discussing program content with friends and family; and social competence and support. Focus group participants described benefits from the Manhood 2.0 content (i.e., full range of contraceptive methods, sexual consent, gender norms) and delivery (i.e., reflective discussion, nonjudgmental facilitators). Findings suggest that Manhood 2.0 is a promising SRH program for young men. [ABSTRACT FROM AUTHOR]

Rank-based methods are frequently used in the life sciences, and in the empirical sciences in general. Among the best-known examples of nonparametric rank-based tests are the Wilcoxon-Mann-Whitney test and the Kruskal–Wallis test. However, recently, potential pitfalls and paradoxical results pertaining to the use of traditional rank-based procedures for more than two samples have been highlighted, and the so-called pseudo-ranks have been proposed as a remedy for this type of problems. The aim of the present article is twofold: First, we show that pseudo-ranks might also behave counterintuitively when splitting up groups. Second, since the use of pseudo-ranks leads to a slightly different interpretation of the results, we provide some guidance regarding the decision for one or the other approach, in particular with respect to interpretability and generalizability of the findings. It turns out that the choice of the reference distribution, to which the individual groups are compared, is crucial. The practically relevant implications of these aspects are illustrated by a discussion of a dataset from epilepsy research. Summing up, one should decide based on thorough case-by-case considerations whether ranks or pseudo-ranks are appropriate. [ABSTRACT FROM AUTHOR]

Although horseback riding is not specifically mentioned in the recommendations for different age groups regarding the level of physical activity necessary for good health, its practice continues to grow in popularity throughout the world. Despite being a minority discipline, it has some characteristics that make it an opportunity for its participants to be active people, so it is important to understand what are the perceived health benefits and barriers to participation. The aim of the study is to describe and analyze the perceived health benefits and barriers in horseback riding among riders categorized by level and age, in order to promote physical activity through these benefits and to overcome the barriers. An online version of the EBBS (Exercise Benefits/Barriers Scale) was used to analyze benefits and barriers. The sample consisted of 2,651 participants (95.9% women and 4.1% men) in an equestrian event, distributed in four age groups (79.4% up to 25 years, 11.5% between 26 and 35, 7.9% between 36 and 50, and 1.2 older than 50 years). Perceived benefits and participation barriers to horseback riding were analyzed. The factor analysis identified and confirmed five benefit factors and four barrier factors. Benefit factors were significantly correlated among them but barriers were less interrelated. Higher ages were associated to larger benefits and less barrier effects. Benefit and barrier differences were larger between amateur and professional riders, compared to gender differences. [ABSTRACT FROM AUTHOR]

Background. Previous animal studies have shown a protective effect of 5-phosphodiesterase inhibitors on cancer therapeutics-related cardiac dysfunction (CTRCD) of anthracyclines. Aim. The aim of this study was to evaluate the clinical effect of sildenafil on the primary prevention of CTRCD in human. Materials and Methods. In this randomized double-blind clinical trial, the primary end point was efficacy in preventing the reduction of left ventricular ejection fraction (LVEF). The intervention group patients received sildenafil at a dose of 25 milligrams twice a day before starting the chemotherapeutic regimen, and the control group received placebo. All the patients at baseline and after the 6-month follow-up underwent 4D and speckle-tracking echocardiography and cardiac MRI, accompanied by hs-troponin I and NT-Pro-BNP measurement. Results. Sixty patients were enrolled in this study, and data from 52 patients (24 patients in the intervention group and 28 patients in the control group) were used in the final analysis. Our findings showed that in the intervention and control groups, LVEF was dropped from 61.28 ± 7.36 to 51.57 ± 7.67 (difference (D) = −9.71 ± 11.95, p = 0.003) and from 57.9 ± 7.29 to 50.2 ± 7.02% (D = −7.7 ± 5.93; p = 0.001), respectively (between-group difference = −2.01%, p = 0.26). CTRCD was detected in 11 patients in the control group (42.8%) and 10 in the intervention group (41.6%, p = 0.51). Conclusion. Consumption of sildenafil for primary prevention of anthracycline-induced cardiac toxicity seems to be unbeneficial. This trial is registered with IRCT20180506039554N1. [ABSTRACT FROM AUTHOR]

There is global acknowledgment that humane methods in animal research are a priority, but few environmental effects monitoring programs use nonlethal methods for fish. The goal of the present study was to determine the impacts of sampling small volumes of blood in larger-bodied fish on survival and healing. In addition to evaluating survival following blood sampling, we evaluated the utility of dried blood spots as an alternative for sample processing and storage in the field. In our approach, we housed 80 rainbow trout (Oncorhynchus mykiss) in our flow-through aquatic facility. We then anaesthetized using MS-222 and sampled 1 μl/g bw of blood via puncture of the caudal vasculature. We tested four different post-blood sampling treatments on the puncture wound: 1. application of liquid bandage; 2. a swab of betadine; 3. a swab of fish mucous; and 4. compared survival outcomes to a group where no post-treatment was performed (negative control). Overall, we observed 90% survival among all treatments, with the most effective approach being the negative control (100% survival). Based upon these results, we repeated the blood sampling with no-post treatment by housing 20 rainbow trout (not previously tested upon) in cages at a nearby creek and monitored survival for 2 weeks post sampling. The survival rate was 95% with full healing of the puncture site in all subjects. In addition to this, we tested the efficacy of dry blood spotting on proteomic, lipidomic and amino acid analysis as an alternative method for blood sample processing and storage. It was found that dried plasma spotting using parafilm in conjunction with a modified Bligh-Dyer extraction offered the best balance for good recovery of protein, lipid and amino acids relative to wet plasma and Noviplex dried plasma spot cards. In this article, we will present the detailed results of these combined studies and describe what we have determined to be the safest non-lethal blood sampling protocol. [ABSTRACT FROM AUTHOR]

The study aim was 2-fold (i) to describe and compare the in-season variations of acute: chronic workload ratio (ACWR) coupled, ACWR uncoupled, and exponentially weighted moving average (EWMA) through session-rated perceived exertion (s-RPE), total distance (TD), high-speed running distance (HSRD), and sprint distance across different periods of a professional soccer season (early, mid, and end-season) between starters and non-starters; (ii) to analyze the relationship the aforementioned measures across different periods of the season for starters and non-starters. Twenty elite soccer players (mean ± SD age, 29.4 ± 4.4 y; height, 1.8 ± 0.1 m; and body mass, 74.8 ± 2.3 kg). They were divided into starter and non-starter groups and were evaluated for 20 weeks. ACWR had general changes throughout the season. At the beginning and end of the mid-season, the highest ACWR was observed in three parameters: s-RPE, TD, and HSRD. ACWR and EWMA through sprint distance were higher at the beginning of the early-season than at any other time of the season. The ACWR coupled of s-RPE shows a significant higher value for non-starters than starters (p = 0.015; g = −1.01 [−1.98, −0.09]) and the ACWR coupled of TD shows a significant higher value for starters than non-starters in early-season (p < 0.01; g = 3.01 [1.78, 4.46]) and shows a significant higher value for non-starters than starters in mid-season (p < 0.01; g = −2.52 [−3.83, −1.39]), and end-season (p < 0.01; g = −2.57 [−3.89, −1.43]). While the EWMA of TD shows a significant higher value for starters than non-starters in early-season (p < 0.01; g = 2.25 [1.17, 3.49]) and mid-season (p < 0.01; g = 2.42 [1.31, 3.71]), and shows a significant higher value for non-starters than starters in end-season (p < 0.01; g = −2.23 [−3.47, −1.16]). Additionally, we found some correlations between external and internal load measures during three periods of the in-season. The study's main finding was that the indexes of ACWR and EWMA were useful to detect differences between period and between playing status with the exception for the sprint variable. In addition, the necessary work for non-starter players' improvement is not done during training, and these players lose their readiness as the season progresses. Consequently, these players perform poorly during the match. Therefore, coaches and their staff should consider devising new activities to keep non-starter players physically fit. This deficit must be accounted for in training because they compete in fewer matches and have less burden than starters. [ABSTRACT FROM AUTHOR]

Background: The complement system plays an important role in pathophysiology of cardiovascular disease (CVD), and might be involved in accelerated atherogenesis in rheumatoid arthritis (RA). The role of complement activation in response to treatment, and in development of premature CVD in RA, is limited. Therefore, we examined the effects of methotrexate (MTX) and tumor necrosis factor inhibitors (TNFi) on complement activation using soluble terminal complement complex (TCC) levels in RA; and assessed associations between TCC and inflammatory and cardiovascular biomarkers. Methods: We assessed 64 RA patients starting with MTX monotherapy (n = 34) or TNFi with or without MTX co-medication (TNFi±MTX, n = 30). ELISA was used to measure TCC in EDTA plasma. The patients were examined at baseline, after 6 weeks and 6 months of treatment. Results: Median TCC was 1.10 CAU/mL, and 57 (89%) patients had TCC above the estimated upper reference limit (<0.70). Compared to baseline, TCC levels were significantly lower at 6-week visit (0.85 CAU/mL, p<0.0001), without significant differences between the two treatment regimens. Notably, sustained reduction in TCC was only achieved after 6 months on TNFi±MTX (0.80 CAU/mL, p = 0.006). Reductions in TCC after treatment were related to decreased C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and interleukin 6, and increased levels of total, high and low-density lipoprotein cholesterol. Similarly, baseline TCC was significantly related to baseline CRP, ESR and interleukin 6. Patients with endothelial dysfunction had higher baseline TCC than those without (median 1.4 versus 1.0 CAU/mL, p = 0.023). Conclusions: Patients with active RA had elevated TCC, indicating increased complement activation. TCC decreased with antirheumatic treatment already after 6 weeks. However, only treatment with TNFi±MTX led to sustained reduction in TCC during the 6-month follow-up period. RA patients with endothelial dysfunction had higher baseline TCC compared to those without, possibly reflecting involvement of complement in the atherosclerotic process in RA. [ABSTRACT FROM AUTHOR]

Background : There are few standardized measures available to assess executive function (EF) in a naturalistic setting for children. The Children's Cooking Task (CCT) is a complex test that has been specifically developed to assess EF in a standardized open-ended environment (cooking). The aim of the present study was to evaluate the internal consistency, inter-rater reliability, sensitivity and specificity, and also convergent and divergent validity of the Norwegian version of CCT among children with pediatric Acquired Brain Injury (pABI) and healthy controls (HCs). Methods : The present study has a cross-sectional design, based on baseline data derived from a multicenter RCT. Seventy-five children with pABI from two university hospitals with parent-reported executive dysfunction and minimum of 12 months since injury/completed cancer therapy, as well as 59 HCs aged 10–17 years, were assessed with CCT using total errors as the main outcome measure. The pABI group completed tests assessing EF (i.e., inhibition, cognitive flexibility, working memory, and planning) on the impairment level within the ICF framework (performance-based neuropsychological tests and the Behavioral Assessment of the Dysexecutive Syndrome for Children), and on the participation level (questionnaires). In addition, they completed tests of intellectual ability, processing speed, attention, learning, and memory. Finally, overall functional outcome (pediatric Glasgow Outcome Scale-Extended) was evaluated for the children with pABI. Results : Acceptable internal consistency and good inter-rater reliability were found for the CCT. Children with pABI performed significantly worse on the CCT than the HCs. The CCT identified group membership, but the sensitivity and specificity were overall classified as poor. Convergent validity was demonstrated by associations between the CCT and performance-based tests assessing inhibition, cognitive flexibility, and working memory, as well as teacher-reported executive dysfunction (questionnaires). Divergent validity was supported by the lack of association with performance-based measures of learning and memory, attention, and verbal intellectual ability. However, there was a moderate association between the CCT and performance-based tests of processing speed. Lastly, better performance on the CCT was associated with a better functional outcome. Conclusion : Our study with a relatively large sample of children with pABI and HC's demonstrated good psychometric properties of the CCT. CCT performance was associated with the overall level of disability and function, suggesting that CCT is related to the level of activity in everyday life and participation in society. Hence, our study suggests that the CCT has the potential to advance the assessment of EF by providing a valid analysis of real-world performance. Nevertheless, further research is needed on larger samples, focusing on predictors of task performance, and evaluating the ability of CCT to detect improvement in EF over time. The patterns of error and problem-solving strategies evaluated by the CCT could be used to inform neuropsychological rehabilitation treatmentand represent a more valid outcome measure of rehabilitation interventions. [ABSTRACT FROM AUTHOR]

This study examines why non-accounting graduates return to school to pursue a degree and career in accounting ("converts"). Understanding why converts gave accounting a chance the second time around informs the profession and academia on how to more effectively identify and recruit high-quality students with diverse skills and backgrounds into accounting. We interview 16 converts and survey 100 accounting graduates. We identify the factors influencing converts' accounting choice and contrast them with those influencing their first degree choice and with those of traditional accounting graduates. Results show converts first need to "discover" accounting, then pursue it based on practical considerations such as job characteristics and earnings potential rather than passion for the topic, which is more salient for traditional graduates. This study demonstrates that converts are a unique source of talent as they already possess many of the skills highly valued by the accounting profession and that traditional graduates often lack. Data Availability: Data are available from the authors upon request. [ABSTRACT FROM AUTHOR]

Depression and personality traits are independent predictors of dementia or cognitive impairment. Despite the well-established relationship between these two psychosocial factors and dementia, no research has been documented on how personality traits can influence dementia in older adults exhibiting depressive symptoms. This study explores the influence of personality traits on the association between change in depression and dementia in old age. A population-based longitudinal cohort study involving two waves of data collected 5 years apart, containing 2210 American older adults, from the National Social Life, Health, and Aging Project to explore if personality traits influence how change in depression predicts the development of dementia. We assessed these relationships while adjusting for sociodemographic characteristics. Change in depression increased the likelihood of dementia at T2 by 4.2% (AOR = 1.04, p = 0.019) in the co-variate adjusted model. Personality traits, overall, did not influence how depression predicts the development of dementia. However, agreeableness individually nullified the effect of depression on the development of dementia, whereas extraversion was the only personality trait that significantly predicted dementia. Prosocial behaviors should be promoted in old age as these appear to be protective. In addition, early life education and a strong social support can keep the depression–dementia spectrum at bay in old age. [ABSTRACT FROM AUTHOR]

The main goal of this study is to examine financial inclusion and related factors in rural South Wollo Zone areas. The binary logit model, primary and secondary data, and multi-stage sampling techniques were all applied in the study. Only 20.72 percent of those questioned in the rural South Wollo zone were given access to formal financial institutions, leaving 79.28 percent of those who were excluded. According to the report, access to traditional financial institutions is influenced favorably by factors such as affordability, financial literacy, age, and secondary education in rural areas, as well as the availability of Islamic banking services. Both the inability of rural inhabitants to access formal financial institutions and their lack of trust in traditional financial institutions represent significant obstacles. The study also looks into the expensive replacement of formal financial institutions in rural areas by traditional financial groups. Based on our research, we recommend that the government and other relevant organizations seek to improve the country's degree of financial inclusion in rural areas by offering formal financial services at a reasonable cost and by boosting the financial capacity of rural low-income groups. [ABSTRACT FROM AUTHOR]

Background and purpose -- Intraoperative periprosthetic femoral fractures (IPFFs) can occur during primary total hip arthroplasty (THA). We describe the incidence of IPFFs during THA in Norway and estimate potential risk factors that could be associated with IPFF Patients and methods -- Data from the Norwegian Arthoplasty Register (1987--2020) was used: 2,268 IPFFs from 218,423 primary THAs in 172,598 patients. The following factors were analyzed: sex, age, diagnosis, previous operation on the same hip, surgical approach, and stem fixation technique. Association of these factors with IPFF risk was assessed using multivariable Poisson regression. Results -- IPFF occurred during 2,268 operations with an incidence of 1.0% among all primary THAs. The risk of IPFF was associated with female sex (relative risk 1.8; 99% CI 1.5--2.1), age 80--90 years and age over 90 years (compared with age 60--70 years: 1.3; CI 1.0--1.6 and 2.6; CI 1.6--4.3, respectively), non-osteoarthritis diagnoses (2.2; CI 1.9--2.6), previous surgery to the same hip (1.8; CI 1.5--2.2), lateral approach (compared with the posterior approach: 1.5; CI 1.1--2.0), and cementless stem fixation (2.7; CI 2.0--3.6). Interpretation -- Surgeons should be aware of the factors associated with an increased risk of IPFF: female sex, age above 80 years, non-osteoarthritis diagnoses, and previous surgery to the same hip. Cemented stem fixation and posterior approach should be favored in high-risk patients, such as elderly women. [ABSTRACT FROM AUTHOR]

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The process of aging leads to changes in functional abilities, fitness levels, level of physical activity, and body mass index (BMI), all of which causes changes in the quality of life. The current study aims to determine the association between the level of physical activity (PA) and BMI, and quality of life (QoL) among elderly women. The total sample numbered 156 women, with an average age of 67.7 ± 5.6 years. To determine the level of physical activity, the self-reported International Physical Activity Questionnaire Long Form (IPAQ-LF), was used. To calculate the values of the BMI, the standard procedure recommended by the World Health Organization was used. Quality of life was evaluated using the short form of the WHOQOL-BREF questionnaire designed by the World Health Organization. All the data were processed using the statistical package for data analysis SPSS 20.0. Pearson's correlation analysis shows statistically significant relations at the level of p < 0.01 between PA and Physical health in Housework = 0.36, Leisure time PA = 0.27, Walking = 0.24, Moderate PA 0.43, Total PA = 0.43, while the correlations between the variables at the significance level of p < 0.05 were determined in PA in transportation = 0.19 and High-intensity PA = 0.16. Multiple linear regression analysis of different levels of PA as independent variables on individual domains of QoL shows that there is an association of PA and Physical health (Sig = 0.000), more precisely, Total PA is statistically the most closely related to Physical health (Sig = 0.000), and then follows PA at work and Social relations (Sig = 0.036). Similar results were obtained when BMI is added to model A. In contrast to model A, model B shows a statistically significant association between PA and BMI with the environmental domain of QoL (Sig = 0.001). The results of the current study indicate that high- and moderate-intensity physical activity both have benefits for physical health, whereas moderate PA showed higher significance levels. Results also show that elderly women with higher BMI values achieve better results in the environmental domain of QoL. [ABSTRACT FROM AUTHOR]

Background and Objectives : Neurodegeneration and vascular burden are the two most common causes of post-stroke cognitive impairment. However, the interrelationship between the plasma beta-amyloid (Aβ) and tau protein, cortical atrophy and brain amyloid accumulation on PET imaging in stroke patients is undetermined. We aimed to explore: (1) the relationships of cortical thickness and amyloid burden on PET with plasma Aβ40, Aβ42, tau protein and their composite scores in stroke patients; and (2) the associations of post-stroke cognitive presentations with these plasma and neuroimaging biomarkers. Methods : The prospective project recruited first-ever ischemic stroke patients around 3 months after stroke onset. The plasma Aβ40, Aβ42, and total tau protein were measured with the immunomagnetic reduction method. Cortical thickness was evaluated on MRI, and cortical amyloid plaque deposition was evaluated by 18F-florbetapir PET. Cognition was evaluated with Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS), Dementia Rating Scale-2 (DRS-2). Results : The study recruited 24 stroke patients and 13 normal controls. The plasma tau and tau*Aβ42 levels were correlated with mean cortical thickness after age adjustment. The Aβ42/Aβ40 ratio was correlated with global cortical 18F-florbetapir uptake value. The DRS-2 and GDS scores were associated with mean cortical thickness and plasma biomarkers, including Aβ42/Aβ40, tau, tau*Aβ42, tau/Aβ42, and tau/Aβ40 levels, in stroke patients. Conclusion : Plasma Aβ, tau, and their composite scores were associated with cognitive performance 3 months after stroke, and these plasma biomarkers were correlated with corresponding imaging biomarkers of neurodegeneration. Further longitudinal studies with a larger sample size are warranted to replicate the study results. [ABSTRACT FROM AUTHOR]

Cognitive function following acute ischemic stroke (AIS) is critical to prognosis and quality of life. Hypertension is a risk factor for stroke and is associated with post stroke cognitive impairment (PSCI). However, the optimal blood pressure parameters after AIS is unknown. This is a sub‐study of the Impairment of CognitiON and Sleep after acute ischemic stroke or transient ischemic attack in Chinese patients (ICONS) study conducted between August 2015 and March 2018. Cognition was assessed at two‐week (2w), three‐month (3 m), and twelve‐month (12 m) by Montreal Cognitive Assessment (MoCA). A total of 682 participants who met the inclusion criteria were enrolled. The primary outcome was cognitive changes after 3 and 12 months post stroke. Among 682 participants, the mean age was 59.35 ± 10.40 years and 72.29% were men. PSCI patients with high systolic blood pressure (SBP ≥140 mm Hg) at 3 m not only had worse cognition as evidenced by MoCA scores at 3 m but also predicted worse scores at 12 m. When participants were stratified into cognitively stable/improved (MoCA score ≥0, 2w vs. 12 m) and cognitively impaired (MoCA score ≤‐2, 2w vs. 12 m), those with high SBP were more likely to be cognitively impaired (OR 2.17, 95%CI 1.12–4.21, p <.05) and less likely to be cognitively stable/improved (OR 0.66, 95%CI 0.44–0.99, p <.05). SBP more than 140 mm Hg is associated with worse cognitive performance after ischemic stroke. Patients with SBP lower than 140 mm Hg have better cognitive outcome at 3‐month and 1 year after stroke. [ABSTRACT FROM AUTHOR]

A sample of 198 supercells are investigated to determine if a radar proxy for the area of the storm midlevel updraft may be a skillful predictor of imminent tornado formation and/or peak tornado intensity. A novel algorithm, a modified version of the Thunderstorm Risk Estimation from Nowcasting Development via Size Sorting (TRENDSS) algorithm is used to estimate the area of the enhanced differential radar reflectivity factor (ZDR) column in Weather Surveillance Radar–1988 Doppler data; the ZDR column area is used as a proxy for the area of the midlevel updraft. The areas of ZDR columns are compared for 154 tornadic supercells and 44 nontornadic supercells, including 30+ supercells with tornadoes rated EF1, EF2, and EF3; 8 supercells with EF4+ tornadoes also are analyzed. It is found that (i) at the time of their peak 0–1-km azimuthal shear, nontornadic supercells have consistently small (<20 km2) ZDR column areas, while tornadic cases exhibit much greater variability in areas; and (ii) at the time of tornadogenesis, EF3+ tornadic cases have larger ZDR column areas than tornadic cases rated EF1/2. In addition, all eight violent tornadoes sampled have ZDR column areas > 30 km2 at the time of tornadogenesis. However, only weak positive correlation is found between ZDR column area and both radar-estimated peak tornado intensity and maximum tornado path width. Planned future work that focuses on mechanisms linking updraft size and tornado formation and intensity is summarized and the use of the modified TRENDSS algorithm, which is immune to ZDR bias and thus ideal for real-time operational use, is emphasized. [ABSTRACT FROM AUTHOR]