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Abstract Background The way physical activity (PA) and sedentary behaviour (SB) independently and interactively modify the age‐related decline in physical capacity remains poorly understood. This cross‐sectional study investigated the independent and interactive associations of PA and SB with physical function and performance throughout the adult life course. Methods Data from 499 community‐dwelling adults (63% female) aged 20–92 years, involved in the INSPIRE Human Translational Cohort, were used in this cross‐sectional study. Daily time spent on moderate‐to‐vigorous PA (MVPA, min/day) and SB (h/day) was measured with activPAL triaxial accelerometers. Physical function and performance were assessed through the measurement of the 4‐m usual gait speed (m/s), handgrip strength (kg), lower‐limb strength (isokinetic knee extension torque, N·m), estimated lower‐limb power (five‐time chair‐rise test performance, s) and cardiorespiratory fitness (V̇O2max, mL/kg/min). Confounder‐adjusted multiple linear and curvilinear regressions were performed to investigate how MVPA, SB and their interactions were associated with the physical outcomes (all square root‐transformed except gait speed) throughout the adulthood spectrum. Results Interaction analyses revealed that the combination of higher levels of MVPA with lower levels of SB favourably reshaped the negative relationship between handgrip strength and age (age2 × SB × MVPA: B = −7E‐08, SE = 3E‐08, P

Knowledge about embodied creativity is in its infancy. In circus arts, performers are nowadays 'owning' their creativity making this performance domain fruitful to study embodied creativity. Building on socio-cultural creativity perspectives and radical embodied cognitive sciences, the current study aimed at exploring movement creativity by tracking the journey of embodied ideas in a Circus School. Specifically, this research questioned how the interactions between actors, audiences, affordances, and actions support the emergence and evolution of movement ideas. A narrative ethnographic research design, gathering process observations in situ, was used to scrutinize the movement ideas generated by student-artists, teachers, and artistic advisors over a 4-month period. Reflexive thematic analysis led to the design of an exhaustive mapping which illustrates the key findings. Namely, the journey of an embodied idea is influenced by stimulating spaces and collaborative socio-cultural environment which ignite the actors' desire to create. This desire, in turn, unfolds into multiple ideational pathways paved with research strategies (e.g., improvisation, constraints, variability) and emotions (i.e., pleasant and unpleasant). Embodied ideas then go through an assessment process leading (or not) to its growth. Results are discussed in light of embodied, pedagogical, and emotional considerations offering an alternative to the conceptualization of idea.

Pyrogenic carbon (PyC) constitutes an important pool of soil organic carbon and may remain in soil over millennia. Its accurate quantification in soil is necessary to monitor the evolution of soil carbon stocks and fluxes. This study tested new direct approaches to quantify PyC enrichment in soil, using three protocols based on the Rock-Eval® thermal method. Six industrial biochars and four cultivated soils were mixed at five different biochar/soil ratios from 0.05 % to 1 % (w/w). Biochar-C emissions could be identified in the CO2 signal from the oxidation stage (CO2oxi) between 410 °C and 610 °C, independently from carbon and carbonate contents from the original unamended soil. Based on this signal and using a reference sample, the protocol 3 allowed for a good estimation of the PyC enrichment relatively to the reference sample. This protocol is thus well adapted to monitor biochar addition in agricultural soils. However, the use of a reference sample, chosen as the sample with the lowest value of thermo-resistant organic carbon (CorgTR), may be tricky for heterogeneous surface areas and soil profiles. In the latter context, both protocols 1 and 2 are alternative methods to quantify CorgTR from biochar and soil without the need of a reference sample, although less accurate than protocol 3. Protocol 2, based on a more precise identification of the biochar-derived peak of CO2oxi, resulted in more accurate values than protocol 1. However, the use of protocol 2 is suitable when the biochar-derived peak is easily distinguishable from the peaks derived from both thermo-resistant SOM and PyC present in the original unamended soil. In conclusion, the Rock-Eval® thermal method turns out to be a good tool to quantify biochar-C in cultivated soil and is fully adapted in field experiments – in which, the initial content in biochar is controlled – aiming to decipher the potential benefits of biochar on soil functioning and related ecosystem services.

Conventional numerical solutions developed to describe the geomechanical behavior of rock interfaces subjected to differential load emphasize peak and residual shear strengths. The detailed analysis of pre- and post-peak shear stress-displacement behavior is central to various time-dependent and dynamic rock mechanic problems such as rockbursts and structural instabilities in highly stressed conditions. The complete stress-displacement surface (CSDS) model was developed to describe analytically the pre- and post-peak behavior of rock interfaces under differential loads. Original formulations of the CSDS model required extensive curve-fitting iterations which limited its practical applicability and transparent integration into engineering tools. The present work proposes modifications to the CSDS model aimed at developing a comprehensive and modern calibration protocol to describe the complete shear stress-displacement behavior of rock interfaces under differential loads. The proposed update to the CSDS model incorporates the concept of mobilized shear strength to enhance the post-peak formulations. Barton's concepts of joint roughness coefficient (JRC) and joint compressive strength (JCS) are incorporated to facilitate empirical estimations for peak shear stress and normal closure relations. Triaxial/uniaxial compression test and direct shear test results are used to validate the updated model and exemplify the proposed calibration method. The results illustrate that the revised model successfully predicts the post-peak and complete axial stress–strain and shear stress–displacement curves for rock joints.

Informal caregivers’ own quality of life, health status, and determinants are poorly understood despite their concern for the health of the individuals they assist. To compare the quality of life and the health determinants of older informal caregivers with those of older adults without caregiving responsibilities. An online survey was designed to investigate the quality of life and the health determinants of people aged 65 years and over, with a focus on informal caregivers. In addition to socio-demographic data, the number of informal caregivers was ascertained and the Zarit scale of caregiver burden was applied. Quality of life (SF-12) and health determinants (access to technology and level of physical activity (IPAQ)) were assessed and compared between informal caregivers and non-caregivers. A total of 111 participants were included in the study (70 ± 3.83 years, 71.2% women). The majority of respondents (91.8%) were Belgian. One-third of the respondents identified themselves as informal caregivers and declared themselves as having a severe burden (61.9 ± 15.2/88). Socio-demographic characteristics and access to technology were similar between informal caregivers and non-caregivers (p > 0.05). However, informal caregivers had a lower SF-12 score in the mental score domain (44.3 ± 10.2 vs. 50.7 ± 7.0; p = 0.004) and a lower level of physical activity (434 ± 312 METS/min/week vs. 1126 ± 815 METS/min/week; p = 0.01) than their peers. Informal caregivers reported a lower quality of life and a lower level of physical activity than their peers. Given the recognized importance of physical activity for overall health, this survey highlights the need to promote physical activity among older informal caregivers.

Prostate cancer is the most common cancer among men. An accurate diagnosis of its severity at detection plays a major role in improving their survival. Recently, machine learning models using biomarkers identified from Raman micro-spectroscopy discriminated intraductal carcinoma of the prostate (IDC-P) from cancer tissue with a ≥85  %   detection accuracy and differentiated high-grade prostatic intraepithelial neoplasia (HGPIN) from IDC-P with a ≥97.8  %   accuracy. To improve the classification performance of machine learning models identifying different types of prostate cancer tissue using a new dimensional reduction technique. A radial basis function (RBF) kernel support vector machine (SVM) model was trained on Raman spectra of prostate tissue from a 272-patient cohort (Centre hospitalier de l'Université de Montréal, CHUM) and tested on two independent cohorts of 76 patients [University Health Network (UHN)] and 135 patients (Centre hospitalier universitaire de Québec-Université Laval, CHUQc-UL). Two types of engineered features were used. Individual intensity features, i.e., Raman signal intensity measured at particular wavelengths and novel Raman spectra fitted peak features consisting of peak heights and widths. Combining engineered features improved classification performance for the three aforementioned classification tasks. The improvements for IDC-P/cancer classification for the UHN and CHUQc-UL testing sets in accuracy, sensitivity, specificity, and area under the curve (AUC) are (numbers in parenthesis are associated with the CHUQc-UL testing set): +4  %   (+8  %  ), +7  %   (+9  %  ), +2  %   (6%), +9 (+9) with respect to the current best models. Discrimination between HGPIN and IDC-P was also improved in both testing cohorts: +2.2  %   (+1.7  %  ), +4.5  %   (+3.6  %  ), +0  %   (+0  %  ), +2.3 (+0). While no global improvements were obtained for the normal versus cancer classification task [+0  %   (-2  %  ), +0  %   (-3  %  ), +2  %   (-2  %  ), +4 (+3)], the AUC was improved in both testing sets. Combining individual intensity features and novel Raman fitted peak features, improved the classification performance on two independent and multicenter testing sets in comparison to using only individual intensity features.

BackgroundLow back pain (LBP) is the leading global cause of years lived with disability. Of the biopsychosocial domains of health, social determinants of LBP remain under-researched. Socioeconomic status (SES) may be associated with the onset of new LBP or outcomes of acute LBP, with educational attainment (EA) being a key component of SES. The association between EA and LBP has yet to be the subject of a dedicated review and meta-analysis.PurposeTo review evidence of the association between EA and a) onset or b) outcomes of acute and subacute LBP in the adult general population and to conduct statistical pooling of data where possible.MethodsAn electronic search was conducted in MEDLINE, Embase, CINAHL, and ProQuest from inception to 2nd November 2023 including reference lists to identify relevant prospective studies. Risk of bias (RoB) was assessed using the Quality in Prognostic Studies (QUIPS) tool. Where adequate data were available, estimates were pooled using a random-effects meta-analysis. Overall evidence for each outcome was graded using an adapted GRADE.ResultsAfter screening 8498 studies, 29 were included in the review. Study confounding and attrition were common biases. Data from 19 studies were statistically pooled to explore EA as a predictor of new LBP onset or as prognostic for outcomes of acute or subacute LBP. Pooled results showed no association between EA and the onset of new LBP (OR: 0.927, 95%CI: 0.747 to 1.150; I2 = 0%). For predicting outcomes of acute LBP, compared to those with no more than secondary-level education, post-secondary education or higher was associated with better outcomes of pain (OR: 0.538, 95%CI: 0.432 to 0.671; I2 = 35%) or disability (OR: 0.565, 95%CI: 0.420 to 0.759; I2 = 44%). High heterogeneity (I2>80%) prevented meaningful pooling of estimates for subacute LBP outcomes.ConclusionWe found no consistent evidence that lower EA increases the risk of LBP onset. Lower EA shows a consistent association with worse LBP outcomes measured at least 3 months later after acute onset with inconclusive findings in subacute LBP. Causation cannot be supported owing to study designs. High-quality research is needed on potential mechanisms to explain these effects.

BackgroundThe conventional methods and strategies used for knowledge translation (KT) in academic research often fall short in effectively reaching stakeholders, such as citizens, practitioners, and decision makers, especially concerning complex healthcare issues. In response, a growing number of scholars have been embracing arts-based knowledge translation (ABKT) to target a more diverse audience with varying backgrounds and expectations. Despite the increased interest, utilization, and literature on arts-based knowledge translation over the past three decades, no studies have directly compared traditional knowledge translation with arts-based knowledge translation methods. Thus, our study aimed to evaluate and compare the impact of an arts-based knowledge translation intervention-a circus show-with two traditional knowledge translation interventions (webinar and research report) in terms of awareness, accessibility, engagement, advocacy/policy influence, and enjoyment.MethodsTo conduct this exploratory convergent mixed method study, we randomly assigned 162 participants to one of the three interventions. All three knowledge translation methods were used to translate the same research project: "Rural Emergency 360: Mobilization of decision-makers, healthcare professionals, patients, and citizens to improve healthcare and services in Quebec's rural emergency departments (UR360)."ResultsThe findings revealed that the circus show outperformed the webinar and research report in terms of accessibility and enjoyment, while being equally effective in raising awareness, increasing engagement, and influencing advocacy/policy. Each intervention strategy demonstrates its unique array of strengths and weaknesses, with the circus show catering to a diverse audience, while the webinar and research report target more informed participants. These outcomes underscore the innovative and inclusive attributes of Arts-Based Knowledge translation, showcasing its capacity to facilitate researchers' engagement with a wider array of stakeholders across diverse contexts.ConclusionAs a relevant first step and a complementary asset, arts-based knowledge translation holds immense potential in increasing awareness and mobilization around crucial health issues.

BackgroundAs many as 60% of individuals use a wheelchair long term after a spinal cord injury (SCI). This mode of locomotion leads to chronic decline in lower-extremity weight-bearing activities and contributes to the development of severe sublesional osteoporosis and high rates of fragility fracture. Overground exoskeleton-assisted walking programs provide a novel opportunity to increase lower-extremity weight bearing, with the potential to improve bone health. ObjectiveThe aim of the study is to measure the potential effects of an exoskeleton-assisted walking program on lower-extremity bone strength and bone remodeling biomarkers in individuals with chronic (≥18 months) SCI who use a wheelchair. MethodsIn total, 10 participants completed a 16-week exoskeleton-assisted walking program (34 individualized 1-hour sessions, progressing from 1 to 3 per week). Bone mineral density and bone strength markers (dual-energy x-ray absorptiometry: total body, left arm, leg, total hip, and femoral neck and peripheral quantitative computed tomography: 25% of left femur and 66% of left tibia) as well as bone remodeling biomarkers (formation=osteocalcin and resorption=C-telopeptide) were measured before and after intervention and compared using nonparametric tests. Changes were considered significant and meaningful if the following criteria were met: P5%. ResultsSignificant and meaningful increases were observed at the femur (femoral neck bone mineral content, bone strength index, and stress-strain index) and tibia (cortical cross-sectional area and polar moment of inertia) after the intervention (all P

BACKGROUND:Prostate cancer (PC) is the most frequently diagnosed cancer in North American men. Pathologists are in critical need of accurate biomarkers to characterize PC, particularly to confirm the presence of intraductal carcinoma of the prostate (IDC-P), an aggressive histopathological variant for which therapeutic options are now available. Our aim was to identify IDC-P with Raman micro-spectroscopy (RμS) and machine learning technology following a protocol suitable for routine clinical histopathology laboratories. METHODS AND FINDINGS:We used RμS to differentiate IDC-P from PC, as well as PC and IDC-P from benign tissue on formalin-fixed paraffin-embedded first-line radical prostatectomy specimens (embedded in tissue microarrays [TMAs]) from 483 patients treated in 3 Canadian institutions between 1993 and 2013. The main measures were the presence or absence of IDC-P and of PC, regardless of the clinical outcomes. The median age at radical prostatectomy was 62 years. Most of the specimens from the first cohort (Centre hospitalier de l'Université de Montréal) were of Gleason score 3 + 3 = 6 (51%) while most of the specimens from the 2 other cohorts (University Health Network and Centre hospitalier universitaire de Québec-Université Laval) were of Gleason score 3 + 4 = 7 (51% and 52%, respectively). Most of the 483 patients were pT2 stage (44%-69%), and pT3a (22%-49%) was more frequent than pT3b (9%-12%). To investigate the prostate tissue of each patient, 2 consecutive sections of each TMA block were cut. The first section was transferred onto a glass slide to perform immunohistochemistry with H&E counterstaining for cell identification. The second section was placed on an aluminum slide, dewaxed, and then used to acquire an average of 7 Raman spectra per specimen (between 4 and 24 Raman spectra, 4 acquisitions/TMA core). Raman spectra of each cell type were then analyzed to retrieve tissue-specific molecular information and to generate classification models using machine learning technology. Models were trained and cross-validated using data from 1 institution. Accuracy, sensitivity, and specificity were 87% ± 5%, 86% ± 6%, and 89% ± 8%, respectively, to differentiate PC from benign tissue, and 95% ± 2%, 96% ± 4%, and 94% ± 2%, respectively, to differentiate IDC-P from PC. The trained models were then tested on Raman spectra from 2 independent institutions, reaching accuracies, sensitivities, and specificities of 84% and 86%, 84% and 87%, and 81% and 82%, respectively, to diagnose PC, and of 85% and 91%, 85% and 88%, and 86% and 93%, respectively, for the identification of IDC-P. IDC-P could further be differentiated from high-grade prostatic intraepithelial neoplasia (HGPIN), a pre-malignant intraductal proliferation that can be mistaken as IDC-P, with accuracies, sensitivities, and specificities > 95% in both training and testing cohorts. As we used stringent criteria to diagnose IDC-P, the main limitation of our study is the exclusion of borderline, difficult-to-classify lesions from our datasets. CONCLUSIONS:In this study, we developed classification models for the analysis of RμS data to differentiate IDC-P, PC, and benign tissue, including HGPIN. RμS could be a next-generation histopathological technique used to reinforce the identification of high-risk PC patients and lead to more precise diagnosis of IDC-P.

BackgroundA written action plan (WAP) for managing asthma exacerbations is recommended. ObjectiveWe aimed to compare the effect on unscheduled medical contacts (UMCs) of a digital action plan (DAP) accessed via a smartphone web app combined with a WAP on paper versus that of the same WAP alone. MethodsThis randomized, unblinded, multicenter (offline recruitment in private offices and public hospitals), and parallel-group trial included children (aged 6-12 years) or adults (aged 18-60 years) with asthma who had experienced at least 1 severe exacerbation in the previous year. They were randomized to a WAP or DAP+WAP group in a 1:1 ratio. The DAP (fully automated) provided treatment advice according to the severity and previous pharmacotherapy of the exacerbation. The DAP was an algorithm that recorded 3 to 9 clinical descriptors. In the app, the participant first assessed the severity of their current symptoms on a 10-point scale and then entered the symptom descriptors. Before the trial, the wordings and ordering of these descriptors were validated by 50 parents of children with asthma and 50 adults with asthma; the app was not modified during the trial. Participants were interviewed at 3, 6, 9, and 12 months to record exacerbations, UMCs, and WAP and DAP use, including the subjective evaluation (availability and usefulness) of the action plans, by a research nurse. ResultsOverall, 280 participants were randomized, of whom 33 (11.8%) were excluded because of the absence of follow-up data after randomization, leaving 247 (88.2%) participants (children: n=93, 37.7%; adults: n=154, 62.3%). The WAP group had 49.8% (123/247) of participants (children: n=45, 36.6%; mean age 8.3, SD 2.0 years; adults: n=78, 63.4%; mean age 36.3, SD 12.7 years), and the DAP+WAP group had 50.2% (124/247) of participants (children: n=48, 38.7%; mean age 9.0, SD 1.9 years; adults: n=76, 61.3%; mean age 34.5, SD 11.3 years). Overall, the annual severe exacerbation rate was 0.53 and not different between the 2 groups of participants. The mean number of UMCs per year was 0.31 (SD 0.62) in the WAP group and 0.37 (SD 0.82) in the DAP+WAP group (mean difference 0.06, 95% CI −0.12 to 0.24; P=.82). Use per patient with at least 1 moderate or severe exacerbation was higher for the WAP (33/65, 51% vs 15/63, 24% for the DAP; P=.002). Thus, participants were more likely to use the WAP than the DAP despite the nonsignificant difference between the action plans in the subjective evaluation. Median symptom severity of the self-evaluated exacerbation was 4 out of 10 and not significantly different from the symptom severity assessed by the app. ConclusionsThe DAP was used less often than the WAP and did not decrease the number of UMCs compared with the WAP alone. Trial RegistrationClinicalTrials.gov NCT02869958; https://clinicaltrials.gov/ct2/show/NCT02869958

The abandoned Aldermac mine site, located in the Abitibi- Témiscamingue region of Québec, Canada, is a former polymetallic mine that operated in the 1930s. Over the decades, the sulfidic mine wastes produced by the mine have been exposed to atmospheric conditions, leading to the generation of acid mine drainage (AMD) and contamination of the surrounding environment. In 2008–2009, reclamation works were initiated by the Québec government with the implementation of different techniques based on the characteristics of the different sectors of the mine site. In the southern sector, the production of AMD from the mine wastes pile is controlled by a multilayered cover system, including a 1.5 mm-thick textured high-density polyethylene geomembrane, aimed at limiting ingress of water and oxygen. In 2021, work was carried out to instrument the cover system with an innovative displacement measurement system that was developed and applied to the geomembrane along a sloping transect. The system allows continuous measurements of geomembrane displacement at three locations. This article discusses the installation of these instruments and presents preliminary results. Displacements over a 1-year monitoring period ranged from approximately 4 mm downslope to 32 mm upslope. This corresponded to strains ranged from approximately 0.01% contraction to 0.05% tension.

Fanny Buckinx,1,2 Mylène Aubertin-Leheudre1,2 1Département des Sciences de l’Activité Physique, Groupe de Recherche en Activité Physique Adapté, Université du Québec à Montréal (UQAM), Montréal (Qc), Canada; 2Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal (CRIUGM), Montréal (Qc), CanadaCorrespondence: Mylène Aubertin-Leheudre, Email aubertin-leheudre.mylene@uqam.caAbstract: Menopause is associated with hormonal changes, which could accelerate or lead to sarcopenia. Functional impairment and physical disability are the major consequences of sarcopenia. In order to hamper these negative health outcomes, it appears necessary to prevent and even treat sarcopenia, through healthy lifestyle changes including diet and regular physical activity or through hormonal replacement therapy when appropriate. Therefore, the purpose of this narrative review will be 1) to present the prevalence of sarcopenia in postmenopausal women; 2) to address the risk factors related to sarcopenia in this specific population; and 3) to discuss how to manage sarcopenia among postmenopausal women.Keywords: sarcopenia, menopause, hormones, physical activity, nutrition

Abstract Background Aging is associated with a progressive decline in skeletal muscle mass and strength as well as an increase in adiposity. These changes may have devastating impact on the quality of life of older adults. Mitochondrial dysfunctions have been implicated in aging‐related and obesity‐related deterioration of muscle function. Impairments in mitochondrial quality control processes (biogenesis, fusion, fission, and mitophagy) may underlie this accumulation of mitochondrial dysfunction. High‐intensity interval training (HIIT) was shown to improve muscle and mitochondrial function in healthy young and old adults and to improve body composition in obese older adults. Recent studies also positioned citrulline (CIT) supplementation as a promising intervention to counter obesity‐related and aging‐related muscle dysfunction. In the present study, our objectives were to assess whether HIIT, alone or with CIT, improves muscle function, functional capacities, adipose tissue gene expression, and mitochondrial quality control processes in obese older adults. Methods Eighty‐one‐old and obese participants underwent a 12 week HIIT with or without CIT on an elliptical trainer [HIIT‐CIT: 20 men/25 women, 67.2 ± 5.0 years; HIIT‐placebo (PLA): 18 men/18 women, 68.1 ± 4.1 years]. Handgrip and quadriceps strength, lower limb muscle power, body composition, waist circumference, and functional capacities were assessed pre and post intervention. Vastus lateralis muscle biopsies were performed in a subset of participants to quantify markers of mitochondrial content (TOM20 and OXPHOS subunits), biogenesis (TFAM), fusion (MFN1&2, OPA1), fission (DRP1), and mitophagy (Parkin). Subcutaneous abdominal adipose tissue biopsies were also performed to assess the expression of genes involved in lipid metabolism. Results HIIT‐PLA and HIIT‐CIT displayed improvements in functional capacities (P

Maintaining an acceptable quality of life following a lifetime of chronic diseases and resulting physiologic effects poses a challenge when treating an aging population. In those with Charcot neuroarthropathy, wounds, and infection complicate decision making when considering limb preservation versus amputation. The purpose of this investigation is to describe the clinical characteristics and short-term outcomes of geriatric patients undergoing Charcot reconstruction. A retrospective chart review of patients who underwent Charcot reconstruction from 2016 to 2022 was conducted. Demographics, medical history, deformity type, surgical intervention, discharge planning, and short-term complications were collected. Descriptive statistics were calculated, and clinical characteristics and short-term outcomes were compared between the non-geriatric, adult (A) and geriatric (G) cohorts using Student's t-test or chi-squared test. Overall, 125 patients were reviewed for final analysis. Charcot deformity type, prevalence of wounds, osteomyelitis, and fixation construct did not significantly differ between groups. While the proportion of those experiencing a prolonged admission did not significantly differ between cohorts, the geriatric group showed age-related pathology including delirium and urinary tract infections. While discharge to nursing facilities did differ between groups (G 43% versus A 19%), baseline function did not. The 30-day unplanned readmission and mortality rates did differ between groups, though this difference was not statistically significant. Prior to geriatric Charcot reconstruction, consideration should be given to age-related comorbidities. Specifically, with a greater incidence of age-related complications unrelated to the surgery as well as mortality in the geriatric group, complications should be discussed at length. [ABSTRACT FROM AUTHOR]

Increasing disability-free life expectancy is a crucial issue to optimize active ageing and to reduce the burden of evitable medical costs. One of the main challenges is to develop pragmatic and personalized prevention strategies in order to prevent frailty, counteract adverse outcomes such as falls and mobility disability, and to improve quality of life. Strong evidence reports the effectiveness of exercise interventions to improve various physical parameters and muscle function that are cornerstones of frailty. Other findings also suggest that the interactions between nutrition and physical exercise with or without health behavior promotion prevent the development of frailty. Multimodal programs, including structured exercise, adequate dietary intervention and health behavior promotion, appear increasingly consensual. However, in order for implementation in real-life settings, some pitfalls need to be addressed. In this perspective, structuring and tailoring feasible, acceptable and sustainable interventions to optimize exercise training responses are essential conditions to warrant short, medium and long-term individual benefits. The different components of exercise programs appear to be fairly consensual and effective. However, specific composition of the programs proposed (frequency, intensity, type, time, volume and progressiveness) have to be tailored to individual characteristics and objectives in order to improve exercise responses. The intervention approaches, behavioral strategies and indications for these programs also need to be refined and framed. The main objective of this work is to guide the actions of healthcare professionals and enable them to widely and effectively implement multimodal programs including exercise, nutrition and behavioral strategies in real-life settings.

Few assessment tools have been designed to assess motor creativity, and the existing tools have limitations. To bridge this gap, the current study aimed at designing a new movement creativity assessment tool that considers the unique features underlying the expression of creativity through movement. A modified Delphi technique was used to collect experts' perspective and derive tasks suitable for evaluation of the main features underlying movement creativity. From these expert consultations, 11 tasks measuring up to 6 movement creativity variables (i.e., fluency, originality, imagination, elaboration, appropriateness, flow) were included in the initial PLAY Creativity measurement model. The COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN checklist) were followed to ensure methodological quality. Overall, 367 children from grade 4 to 6 participated in this study. Results indicated strong test-retest, inter, and intra observer reliability. Confirmatory factor analysis revealed an inadequate fit of the hypothesized model leading to some modifications. After combining originality and imagination, and excluding elaboration, the final measurement model provided an adequate fit. PLAY creativity, in its final form, has adequate validity and can be considered a reliable instrument to assess movement creativity in children. This study thus provides a useful tool to assess and promote movement creativity.

Summary: Genome-wide sequencing (GWS) is a standard of care for diagnosis of suspected genetic disorders, but the proportion of patients found to have pathogenic or likely pathogenic variants ranges from less than 30% to more than 60% in reported studies. It has been suggested that the diagnostic rate can be improved by interpreting genomic variants in the context of each affected individual’s full clinical picture and by regular follow-up and reinterpretation of GWS laboratory results.Trio exome sequencing was performed in 415 families and trio genome sequencing in 85 families in the CAUSES study. The variants observed were interpreted by a multidisciplinary team including laboratory geneticists, bioinformaticians, clinical geneticists, genetic counselors, pediatric subspecialists, and the referring physician, and independently by a clinical laboratory using standard American College of Medical Genetics and Genomics (ACMG) criteria. Individuals were followed for an average of 5.1 years after testing, with clinical reassessment and reinterpretation of the GWS results as necessary. The multidisciplinary team established a diagnosis of genetic disease in 43.0% of the families at the time of initial GWS interpretation, and longitudinal follow-up and reinterpretation of GWS results produced new diagnoses in 17.2% of families whose initial GWS interpretation was uninformative or uncertain. Reinterpretation also resulted in rescinding a diagnosis in four families (1.9%). Of the families studied, 33.6% had ACMG pathogenic or likely pathogenic variants related to the clinical indication. Close collaboration among clinical geneticists, genetic counselors, laboratory geneticists, bioinformaticians, and individuals’ primary physicians, with ongoing follow-up, reanalysis, and reinterpretation over time, can improve the clinical value of GWS.

BackgroundIn the midst of successive waves of SARS-CoV-2 variants, the B.1.1.529 (omicron) variant has recently caused a surge in pediatric infections and hospitalizations. This study aimed to describe and compare the symptoms, explorations, treatment and evolution of COVID-19 in hospitalized children during the successive B.1.617.2 (delta) and B.1.1.529 (omicron) waves.MethodsThis observational study was performed in the Pediatric Pulmonology Department of a University Hospital in Paris, France. All hospitalized children aged between 0 and 18 years who tested positive for SARS-CoV-2 using reverse transcription polymerase chain reaction (RT-PCR) in nasopharyngeal swabs from July 15th to December 15th 2021 (delta wave), and from December 15th 2021 to February 28th 2022 (omicron wave) were included.ResultsIn total, 53 children were included, 14 (26.4%) during the delta wave and 39 (73.6%) during the omicron wave (almost three times as many hospitalizations in half the time during the latter wave). During the omicron wave, hospitalized patients were mostly aged < 5 years (90 vs. 71% of all the children during omicron and delta waves, respectively), and tended to have fewer underlying conditions (56 vs. 79% during omicron and delta waves, respectively, p = 0.20). The omicron variant was also responsible for a different clinical presentation when compared to the delta variant, with significantly higher and often poorly tolerated temperatures (p = 0.03) and increased digestive symptoms (p = 0.01). None of the three patients who were older than 12 years were fully vaccinated.ConclusionThe dramatic increase in the hospitalization of children with COVID-19 and the modification of the clinical presentation between the latest delta and omicron waves require pediatricians to remain vigilant. It should also encourage caregivers to ensure vaccination in children older than 5 years, for whom the BNT162b2 COVID-19 vaccine has been deemed safe, immunogenic, and effective.

Abstract Background Physical activity (PA) is recognized as important predictor of healthy aging. However, the influence of the type of voluntary PA as well as age or sex in this relationship is unclear. Thus, we assess the association between current and past PA level and physical performances among voluntary active older adults. Methods Functional capacities (timed Up and Go, sit-to-stand, alternate step test, unipodal balance, grip strength, knee extension strength, estimated muscle power and VO2 max) as well as body composition (DXA: total and appendicular lean masses (LM; kg), fat mass (FM; %)) were measured. Current and last 5-years PA level (time spent on total, aerobic, resistance and body & mind activities) were assessed using an interview. Multiple regressions, adjusted on age, sex and BMI, were performed to assess the relationship between current or past PA level and physical performances. Sub-group analysis, according to the sex (men/women) or age (

Objective: To examine the impact of circus arts instruction in physical education (PE) on the physical literacy of children in Grades 4 and 5. Methods: A clustered, quasi-experimental design was used comparing children in schools with circus arts instruction in physical education (n = 101) with children in socioeconomic status-matched schools using standard PE instruction (n = 110). Physical literacy assessments performed at the beginning and end of one semester using the Physical Literacy Assessment for Youth tools. Results: Significant improvements in motor competence for both groups; endpoint differences favored the circus arts instruction in physical education schools for 15 of 18 movement skills for Grade 5 and 7 of 18 skills for Grade 4 (p < 0.05), with corresponding increases in children's confidence and comprehension of movement terminology, as well as active participation. The gap in motor competence between girls and boys in the circus arts instruction in physical education schools was smaller than in standard PE schools. Conclusions: Circus arts instruction enriched PE can effectively aid in the development of physical literacy in children with greater gender equity.

Senior adults (>age 65) represent almost 20% of the population but account for 48% of hospital bed occupancy. In older adults, hospitalization often results in functional decline (i.e., iatrogenic disability) and, consequently, the loss of autonomy. Physical activity (PA) has been shown to counteract these declines effectively. Nevertheless, PA is not implemented in standard clinical practice. We previously showed that MATCH, a pragmatic, specific, adapted, and unsupervised PA program, was feasible and acceptable in a geriatric assessment unit (GAU) and a COVID-19 geriatric unit. This feasibility study aims to confirm that this tool could be implemented in other geriatric care programs, notably a geriatric rehabilitation unit (GRU) and a post-acute care unit (PACU), in order to reach the maximum number of older patients. Eligibility and consent were assessed by the physician for all the patients admitted to the three units (GAU, GRU, and PACU). The rehabilitation therapist taught each participant one of the five PA programs based on their mobility score on the decisional tree. Implementation (eligibility (%): patients eligible/number admitted and delay of implementation: number of days until prescription); feasibility (adherence (%): number sessions completed/number sessions prescribed and walking time (%): total walking time/time prescribed time); and acceptability (healthcare team (%): tool adequacy (yes/no) and patient: System Usability Scale questionnaire (SUS: x/100)) were evaluated and analyzed using a Kruskal–Wallis ANOVA or Fisher’s exact test. Eligibility was different between the units (GRU = 32.5% vs. PACU = 26.6% vs. GAU = 56.0%; p < 0.001), but the time before implementation was similar (days: GRU = 5.91 vs. PACU = 5.88 vs. GAU = 4.78; p > 0.05). PA adherence (GRU = 83.5% vs. PACU = 71.9% vs. GAU = 74.3%) and walking time (100% in all units) were similar (p > 0.05). Patients (SUS: GRU = 74.6 vs. PACU = 77.2 vs. GAU = 77.2; p > 0.05) and clinicians (adequacy (yes; %): GRU = 78.3%; PACU = 76.0%; GAU = 72.2%; p > 0.05) found MATCH acceptable. Overall, MATCH was implementable, feasible, and acceptable in a GAU, GRU, and PACU. Randomized controlled trials are needed to confirm our results and evaluate the health benefits of MATCH compared with usual care.

In Algeria, the distribution of social housing refers to the population’s expectations towards the state in regards to providing forms of subsistence. This article focuses on the practices and representations of applicants for social housing living in buildings threatening to collapse, in basement and on terraces in impoverished neighborhoods in downtown Oran. Through the material demands for social housing, this article questions the political relations that are established through material mediation. By focusing on objects that materialize social grievances, it explores the ways in which applicants for social housing attempt to construct themselves as rights-holders and assert their right to access this resource in a situation of constraint. This article focuses on three types of material supports - namely precarious housing, documentary devices and banners - to analyze modalities of political subjectivation.

Background When standard endovascular thrombectomy techniques fail to achieve a successful recanalization, it is often necessary to use rescue therapies (RTs). RTs are more commonly used in basilar artery occlusions and conventionally thought to represent “a last resort option.” We sought to study the outcomes of basilar artery occlusion patients who received RT, and further hypothesize that the number of instrumental passes before initiation of RT may be associated with increased risk for poor clinical outcomes. Methods We performed a retrospective analysis of the ETIS (“Endovascular Treatment in Ischemic Stroke”) registry. Our primary analysis included 277 patients who underwent thrombectomy for basilar artery occlusion, of whom 74 patients (26.7%) who received RT, defined as the use of intra‐arterial drugs, angioplasty, or stenting. Primary outcome measures included successful or complete reperfusion (final modified thrombolysis in cerebral infarction ≥2b or 3), functional independence (modified Rankin scale of 0–2), and mortality at 3 months. Results RT patients were more likely to have an atherosclerotic cause than non‐RT patients (46/74 [62.2%] versus 38/203 [18.7%]), were more likely to die (42/74 [56.8%] versus 73/203 [36.0%]), and were less likely to achieve functional independence (12/74 [16.2%] versus 84/203 [41.4%]). In the RT cohort, 17 of 74 patients (23.0%) had 1 pass before RT initiation, and 8 of 17 (47.1%) achieved a modified Rankin scale score of 0 to 2 at 3 months, with a mortality rate of 23.5% (4/17). The chance of achieving good clinical outcome decreased with each additional pass, whereas mortality increased. The odds of mortality at 3 months were highest in the >3 passes group, with an odds ratio of 10.29 (95% CI, 2.42–43.81) compared with 1 pass. None of the 25 patients with >3 passes before RT achieved 3‐month functional independence. Conclusions There is a significant correlation between the number of passes before initiation of RT and 3‐month clinical outcomes in basilar artery occlusion patients.