Search

Purpose: To test the safety and feasibility of a challenging wild trekking 5-day experience and its acute effects on anthropometrics and cardiorespiratory and muscular performance in healthy older adults with mountaineering expertise. Methods: Twelve healthy active volunteers in their sixth decade of life of comparable training status, mountaineering experience and age were recruited. Before and after engaging in a 5-day wild trek ("Selvaggio Blu", Sardinia, Italy), participants underwent a comprehensive evaluation of anthropometrics, cardiorespiratory fitness, muscle strength and flexibility, balance, and lipidic profile. Results: The wild trekking was well tolerated by all participants who, however, reported moderate pain at the ankle joint (mean: 59.2 ± 13.1 mm). Following the trek, suprailiac fold decreased both in men (− 21.9%; p = 0.006) and women (− 34.5%; p = 0.007). Fat mass was also significantly reduced (men: − 8.5%; p = 0.001; women: − 6.6%; p = 0.014). Gender-based differences emerged for energy expenditure, with women displaying higher caloric expenditure to complete the trek (women: 12.88 ± 3.37 kcal/h/kg; men: 9.27 ± 0.89 kcal/h/kg). Likewise, VO2 peak increased only in women (+ 12%; p = 0.013). Center of pressure sway area during closed eyes single stance was found increased, i.e., worsened, both in men (+ 251%; p = 0.027) and women (+ 71%; p = 0.043). Conclusions: With all due caution, especially for balance and proprioception, wild trekking routes offer unique opportunities to rapidly improve anthropometrics, cardiorespiratory and muscular performance. For older adults with technical and physical preparedness for this type of demanding activity, wild trekking has the potential to evolve from a niche activity for alpine mountaineers into a safe and feasible recreational activity and leisure pursuit. [ABSTRACT FROM AUTHOR]

Background: The Centers for Disease Control defines work-related musculoskeletal disorders as disorders of the nerves, muscles, tendons, joints, spinal discs, and cartilage that are caused or exacerbated by the environment or nature of work. Previous meta-analyses have characterized work-related musculoskeletal disorders among interventionists, general surgeons, and other surgical subspecialties, but prevalence estimates, prognosis, and ergonomic considerations vary by study and surgical specialty. Questions/purposes: (1) What is the career prevalence of work-related musculoskeletal disorders in orthopaedic surgeons? (2) What is the treatment prevalence associated with work-related musculoskeletal disorders in orthopaedic surgeons? (3) What is the disability burden of work-related musculoskeletal disorders in orthopaedic surgeons? (4) What is the scope of orthopaedic surgical ergonomic assessments and interventions? Methods: A systematic review of English-language studies from PubMed, MEDLINE, Embase, and Scopus was performed in December 2022 and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies that presented prevalence estimates of work-related musculoskeletal disorders or assessed surgical ergonomics in orthopaedic surgery were included. Reviews, case reports, gray literature (conference abstracts and preprints), and studies with mixed-surgeon (nonorthopaedic) populations were excluded. The search yielded 5603 abstracts; 24 survey-based studies with 4876 orthopaedic surgeons (mean age 48 years; 79% of surgeons were men) were included for an analysis of work-related musculoskeletal disorders, and 18 articles were included for a descriptive synthesis of ergonomic assessment. Quality assessment using the Joanna Briggs Institute Tool revealed that studies had a low to moderate risk of bias, largely because of self-reporting survey-based methodology. Because of considerable heterogeneity and risk of bias, prevalence outcomes were not pooled and instead are presented as ranges (mean I2 = 91.3%). Results: The career prevalence of work-related musculoskeletal disorders in orthopaedic surgeons ranged from 37% to 97%. By anatomic location, the prevalence of work-related musculoskeletal disorders in the head and neck ranged from 4% to 74%; back ranged from 9% to 77%; forearm, wrist, and hand ranged from 12% to 54%; elbow ranged from 3% to 28%; shoulder ranged from 3% to 34%; hip and thigh ranged from 1% to 10%; knee and lower leg ranged from 1% to 31%; and foot and ankle ranged from 4% to 25%. Of orthopaedic surgeons reporting work-related musculoskeletal disorders, 9% to 33% had a leave of absence, practice restriction or modification, or early retirement, and 27% to 83% received some form of treatment. Orthopaedic surgeons experienced biomechanical, cardiovascular, neuromuscular, and metabolic stress during procedures. Interventions to improve orthopaedic surgical ergonomics have been limited, but have included robotic assistance, proper visualization aids, appropriate use of power tools, and safely minimizing lead apron use. In hip and knee arthroplasty, robotic assistance was the most effective in improving posture and reducing caloric expenditure. In spine surgery, proper use of surgical loupes was the most effective in improving posture. Conclusion: Although the reported ranges of our main findings were wide, even on the low end of the reported ranges, work-related musculoskeletal disability among orthopaedic surgeons appears to be a substantial concern. We recommend that orthopaedic residency training programs incorporate surgical ergonomics or work injury lectures, workshops, and film review (alongside existing film review of surgical skills) into their curricula. We suggest hospitals engage in shared decision-making with surgeons through anonymous needs assessment surveys to implement wellness programs specific to surgeons' musculoskeletal needs. We urge institutions to assess surgeon ergonomics during routine quality assessment of novel surgical instruments and workflows. Level of Evidence: Level III, prognostic study. [ABSTRACT FROM AUTHOR]

Consumer and research activity monitors have become popular because of their ability to quantify energy expenditure (EE) in free-living conditions. However, the accuracy of activity trackers in determining EE in people with Huntington's Disease (HD) is unknown. Research question: Can the ActiGraph wGT3X-B or the Fitbit Charge 4 accurately measure energy expenditure during physical activity, in people with HD compared to Indirect Calorimetry (IC) (Medisoft Ergo Card)? We conducted a cross-sectional, observational study with fourteen participants with mild-moderate HD (mean age 55.7 ± 11.4 years). All participants wore an ActiGraph and Fitbit during an incremental test, running on a treadmill at 3.2 km/h and 5.2 km/h for three minutes at each speed. We analysed and compared the accuracy of EE estimates obtained by Fitbit and ActiGraph against the EE estimates obtained by a metabolic cart, using with Intra-class correlation (ICC), Bland-Altman analysis and correlation tests. A significant correlation and a moderate reliability was found between ActiGraph and IC for the incremental test (r = 0.667)(ICC=0.633). There was a significant correlation between Fitbit and IC during the incremental test (r = 0.701), but the reliability was poor at all tested speeds in the treadmill walk. Fitbit significantly overestimated EE, and ActiGraph underestimated EE compared to IC, but ActiGraph estimates were more accurate than Fitbit in all tests. Significance: Compared to IC, Fitbit Charge 4 and ActiGraph wGT3X-BT have reduced accuracy in estimating EE at slower walking speeds. These findings highlight the need for population-specific algorithms and validation of activity trackers. • First validation of devices to capture energy expenditure in Huntington´s disease • ActiGraph and Fitbit have reduced accuracy in estimating energy expenditure • Hip-worn wearables estimate energy expenditure better than wrist-worn devices [ABSTRACT FROM AUTHOR]

Persons with achondroplasia develop early obesity, which is a comorbidity associated with other complications. Currently, there are no validated specific predictive equations to estimate resting energy expenditure in achondroplasia. We analyzed the influence of body composition on this parameter and determined whether predictive models used for children with standard height are adjusted to achondroplasia. In this cross-sectional study, we measured anthropometric parameters in children with achondroplasia. Fat mass was obtained using the Slaughter skinfold-thickness equation and resting energy expenditure was determined with a Fitmate-Cosmed calorimeter and with predictive models validated for children with average height (Schofield, Institute of Medicine, and Tverskaya). All of the equations yielded a lower mean value than resting energy expenditure with indirect calorimetry (1256±200 kcal/day [mean±SD]) but the closest was the Tverskaya equation (1017 ± 64 kcal/day), although the difference remained statistically significant. We conclude that weight and height have the greatest influence on resting energy expenditure. We recommend studying the relationship between body composition and energy expenditure in achondroplasia in more depth. In the absence of valid predictive models suitable for clinical use to estimate body composition and resting energy expenditure in achondroplasia, it is recommended to use the gold standard methods by taking into account certain anthropometric parameters. [ABSTRACT FROM AUTHOR]

In ubiquitous healthcare systems, energy expenditure estimation based on wearable sensors such as inertial measurement units (IMUs) is important for monitoring the intensity of physical activity. Although several studies have reported data-driven methods to estimate energy expenditure during activities of daily living using wearable sensor signals, few have evaluated the performance while walking at various speeds and inclines. In this study, we present a hybrid model comprising a convolutional neural network (CNN) and long short-term memory (LSTM) to estimate the steady-state energy expenditure under various walking conditions based solely on IMU data. To implement and evaluate the model, we performed level/inclined walking and level running experiments on a treadmill. With regard to the model inputs, the performance of the proposed model based on fixed-size sequential data was compared with that of a method based on stride-segmented data under different conditions in terms of the sensor location, input sequence format, and neural network model. Based on the experimental results, the following conclusions were drawn: (i) the CNN–LSTM model using a two-second sequence from the IMU attached to the lower body yielded optimal performance, and (ii) although the stride-segmented data-based method showed superior performance, the performance difference between the two methods was not significant; therefore, the proposed model based on fixed-size sequential data may be considered more practical as it does not require heel-strike detection. [ABSTRACT FROM AUTHOR]

Objective: was to find out preference for behaviors favorable to the practice of physical activity among schoolchildren and to estimate association with body weight. Materials and Methods: A cross-sectional study involving 578 children in a municipality in southern Brazil was carried out. Children were classified according to their BMI z score. Mothers responded a validated questionnaire to assess children's preferences for behaviors favorable to the practice of physical activity. Multiple linear regression analyses were performed between each instrument question and the BMI z scores. Results: The prevalence of overweight was 36.1%. There was a higher prevalence of behaviors associated with the practice of physical activity. A positive, statistically significant and independent regression coefficient was observed between the lack of interest in playing sports and being overweight; and a negative, statistically significant and independent regression coefficient between the question related to the lack of interest in painting, drawing or reading magazines and lower overweight values. Conclusion: It can be concluded that children showed many behaviors favorable to the practice of physical activity. In addition, children's lack of interest in playing sports and children's interest in painting, drawing or reading magazines, both behaviors that imply lower caloric expenditure, were shown to be associated with excess weight. [ABSTRACT FROM AUTHOR]

Since pedestrians are impacted by solar radiation differently, urban designers must evaluate solar radiation exposure of pedestrian paths adopting an inclusive approach. This paper proposes a maximum threshold of direct solar radiation exposure for pedestrians based on activity, user profile and environmental conditions, defined as the difference between the energy consumption before feeling exhausted and the energy cost of walking. Two users of diverse walking abilities, a young adult and an elderly person with mobility impairment, were characterised by metabolic activity, walking speed and maximum energy capacity. Based on the theoretical framework, the energy budget of young adults to cope with thermal stress was set as three times higher than for the elderly. This framework was used to quantify the contribution of direct solar radiation to energy balance and then classify walkability during clear-sky summer hours; the term 'walkable' referred to environmental conditions allowing users to walk without feeling exhausted. The methodology was tested on an open area and an urban canyon in Milan; applicability by urban designers was key in developing a simplified way to evaluate shading needs. This approach could be applied to evaluate solar radiation exposure of pedestrian paths adopting diverse user experiences as an evaluation criterion. [ABSTRACT FROM AUTHOR]

Objective: This cross-sectional study was conducted on the associations between body composition, energy expenditure and caloric intake among 45 Nigerian breast cancer patients. Methods: Forty-five Nigerian breast cancer patients were measured and analysed for their body composition, energy expenditure and caloric intake. Statistical analyses included a chi-square test, Student's t-test, paired t-test, Spearman correlation and linear regression using Statistical Package for the Social Sciences 23.0. Results: The body fat indices (body mass index (BMI), fat mass index (FMI), and body fats percentage) show that more than 50% of breast cancer patients were either overweight or obese. The Spearman correlation showed that fat-free mass (FFM) was the most strongly correlated with energy expenditure (r = 0.84). BMI and (FMI - fat mass in relation to height) were significantly correlated with the Harris-Benedict equation for energy expenditure (p < 0.001; p = 0.002), but they were not correlated significantly with the Karnofsky performance status. A paired t-test showed that caloric intake was significantly higher than total energy expenditure (p < 0.001). FFM was the best predictor of resting energy expenditure (REE). Conclusion: In conclusion, FFM remains the best predictor of REE. High body mass and high caloric intake indicate the need for support from nutritional programmes. [ABSTRACT FROM AUTHOR]

Aim: This study assessed the impact of dapagliflozin on food intake, eating behaviour, energy expenditure, magnetic resonance imaging (MRI)‐determined brain response to food cues and body composition in patients with type 2 diabetes mellitus (T2D). Materials and Methods: Patients were given dapagliflozin 10 mg once daily in a randomized, double‐blind, placebo‐controlled trial with short‐term (1 week) and long‐term (12 weeks) cross‐over periods. The primary outcome was the difference in test meal food intake between long‐term dapagliflozin and placebo treatment. Secondary outcomes included short‐term differences in test meal food intake, short‐ and long‐term differences in appetite and eating rate, energy expenditure and functional MRI brain activity in relation to food images. We determined differences in glycated haemoglobin, weight, liver fat (by 1H magnetic resonance spectroscopy) and subcutaneous/visceral adipose tissue volumes (by MRI). Results: In total, 52 patients (43% were women) were randomized; with the analysis of 49 patients: median age 58 years, weight 99.1 kg, body mass index 35 kg/m2, glycated haemoglobin 49 mmol/mol. Dapagliflozin reduced glycated haemoglobin by 9.7 mmol/mol [95% confidence interval (CI) 3.91‐16.27, p =.004], and body weight (−2.84 vs. −0.87 kg) versus placebo. There was no short‐ or long‐term difference in test meal food intake between dapagliflozin and placebo [mean difference 5.7 g (95% CI −127.9 to 139.3, p =.933); 15.8 g (95% CI −147.7 to 116.1, p =.813), respectively] nor in the rate of eating, energy expenditure, appetite, or brain responses to food cues. Liver fat (median reduction −4.7 vs. 1.95%), but not subcutaneous/visceral adipose tissue, decreased significantly with 12 weeks of dapagliflozin. Conclusions: The reduction in body weight and liver fat with dapagliflozin was not associated with compensatory adaptations in food intake or energy expenditure. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the effects of combined training (COMB, a combination of moderate-intensity continuous training-MICT and high-intensity interval training-HIIT) vs. continuous MICT administered during a 3-week in-hospital body weight reduction program (BWRP) on body composition, physical capacities, and substrate oxidation in adolescents with obesity. The 3-week in-hospital BWRP entailed moderate energy restriction, nutritional education, psychological counseling, and two different protocols of physical exercise. Twenty-one male adolescents with obesity (mean age: 16.1 ± 1.5 years; mean body mass index [BMI] 37.8 ± 4.5 kg m−2) participated in this randomized control trial study (n:10 for COMB, n:11 MICT), attending ~ 30 training sessions. The COMB group performed 3 repetitions of 2 min at 95% of peak oxygen uptake (V′O2 peak) (e.g., HIIT ≤ 20%), followed by 30 min at 60% of V′O2 peak (e.g., MICT ≥ 80%). Body composition, V′O2 peak, basal metabolic rate (BMR), energy expenditure, and substrate oxidation rate were measured during the first week (W0) and at the end of three weeks of training (W3). The two training programs were equivalent in caloric expenditure. At W3, body mass (BM) and fat mass (FM) decreased significantly in both groups, although the decrease in BM was significantly greater in the MICT group than in the COMB group (BM: − 5.0 ± 1.2 vs. − 8.4 ± 1.5, P < 0.05; FM: − 4.3 ± 3.0 vs. − 4.2 ± 1.9 kg, P < 0.05). V′O2 peak increased only in the COMB by a mean of 0.28 ± 0.22 L min−1 (P < 0.05). The maximal fat oxidation rate (MFO) increased only in the COMB group by 0.04 ± 0.03 g min−1 (P < 0.05). COMB training represents a viable alternative to MICT for improving anthropometric characteristics, physical capacities, and MFO in adolescents with obesity during a 3-week in-hospital BWRP. [ABSTRACT FROM AUTHOR]

In mammals, leptin is an important energy homeostasis hormone produced by adipose tissue. Circulating leptin concentrations correlate positively with fat mass and act in a negative feedback fashion to inhibit food intake and increase energy expenditure, thereby preventing fat gain. For some species, leptin resistance is advantageous during times of year where fat gain is necessary (e.g. prior to hibernation). While the function of leptin in birds remains controversial, seasonal leptin resistance may similarly benefit migratory species. Here, we used the ruby-throated hummingbird (Archilochus colubris) to test the hypothesis that leptin resistance promotes fattening prior to migration. We predicted that during the migratory fattening period, leptin levels should correlate positively with fat mass but should not inhibit food intake or increase energy expenditure, resulting in fattening. We tracked the body (fat) mass, the concentration of leptin-like protein in the urine, and the food intake of 12 captive hummingbirds from August 2021 to January 2022. In a subset of hummingbirds, we also quantified voluntary physical activity as a proxy for energy expenditure. We found remarkable age-related variation in fattening strategies, with juveniles doubling their body fat by mid-September and adults exhibiting only a 50% increase. Changes in fat mass were strongly associated with increased food intake and reduced voluntary activity. However, we found no correlation between leptin-like protein concentration and fat mass, food intake, or voluntary activity. Since increased torpor use has been shown to accelerate migratory fattening in ruby-throated hummingbirds, we also hypothesized that leptin is a mediator of torpor use. In an experimental manipulation of circulating leptin, however, we found no change in torpor use, body fat, or food intake. Overall, our findings suggest that leptin may not act as an adipostat in hummingbirds, nor does leptin resistance regulate how hummingbirds fatten prior to migration. [ABSTRACT FROM AUTHOR]

The recent developments in the design, planning, and operation of distribution systems indicate the need for a modern integrated infrastructure in which participants are managed through the perceptions of a utility company in an economic network (e.g., energy loss reduction, restoration, etc.). The penetration of distributed generation units in power systems are growing due to their significant influence on the key attributes of power systems. As a result, the placement, type, and size of distributed generations have an essential role in reducing power loss and lowering costs. Power loss minimization, investment and cost reduction, and voltage profile improvement combine to form a conceivable goal function for distributed generation allocation in a constrained optimization problem, and they require a complex procedure to control them in the most appropriate way while satisfying network constraints. Such a complex decision-making procedure can be solved by adjusting the dynamic optimal power flow problem to the associated network. The purpose of the present work is to handle the distributed generation allocation problem for photovoltaic units, attempting to reduce energy and investment costs while accounting for generation unpredictability as well as load fluctuation. The problem is analyzed under various scenarios of solar radiation through a stochastic programming technique because of the intense uncertainty of solar energy resources. The formulation of photovoltaic distributed generation allocation is represented as a mixed-integer second-order conic programming problem. The IEEE 33-bus and real-world 136-bus distribution systems are tested. The findings illustrate the efficacy of the proposed mathematical model and the role of appropriate distributed generation allocation. [ABSTRACT FROM AUTHOR]

Senescence is the irreversible decline in physiological functioning and survival with age. While this phenomenon has been studied in a range of different taxa, including seabirds, it has seldom been assessed for both sexes of monomorphic species, and in conservation contexts. Here, we studied the effect of age and sex on the foraging trip characteristics and energetics of the monomorphic Cape gannet (Morus capensis). Between 2017 and 2020, we used GPS recorders and miniaturised three-dimensional accelerometers to obtain data on the foraging trip characteristics and energy expenditure of 39 Cape gannets rearing chicks on Malgas Island, South Africa. This sample included 11 females and 28 males between the ages of 4 and 23 years. No difference in foraging trip characteristics was apparent between sexes or individuals of different ages. The energy expenditure of aging females (> 17 years) was higher than that of aging males. Aging females spent both more energy flying and less energy resting than males, despite similar foraging trip durations and distances. Males spent more energy diving and taking off from the water than females. The age-related sexual differences in energy expenditure presented in our study might reflect niche and/or risk partitioning strategies to ensure adequate provisioning to the chick, or a possible earlier onset of senescence in females relative to males. The higher energy expenditure of aging females, which presumably requires a concomitantly higher energy intake, likely reduces their resilience to environmental change. [ABSTRACT FROM AUTHOR]

Cytochrome b 5 reductase 3 (CYB5R3) activates respiratory metabolism in cellular systems and exerts a prolongevity action in transgenic mice overexpressing this enzyme, mimicking some of the beneficial effects of calorie restriction. The aim of our study was to investigate the role of sex on metabolic adaptations elicited by CYB5R3 overexpression, and how key markers related with mitochondrial function are modulated in skeletal muscle, one of the major contributors to resting energy expenditure. Young CYB5R3 transgenic mice did not exhibit the striking adaptations in carbon metabolism previously detected in older animals. CYB5R3 was efficiently overexpressed and targeted to mitochondria in skeletal muscle from transgenic mice regardless sex. Overexpression significantly elevated NADH in both sexes, although differences were not statistically significant for NAD+, and increased the abundance of cytochrome c and the fission protein DRP-1 in females but not in males. Moreover, while mitochondrial biogenesis and function markers (as TFAM, NRF-1 and cleaved SIRT3) were markedly upregulated by CYB5R3 overexpression in females, a downregulation was observed in males. Ultrastructural changes were also highlighted, with an increase in the number of mitochondria per surface unit, and in the size of intermyofibrillar mitochondria in transgenic females compared with their wild-type controls. Our results support that CYB5R3 overexpression upregulates markers consistent with enhanced mitochondrial biogenesis and function, and increases mitochondrial abundance in skeletal muscle, producing most of these potentially beneficial actions in females. [Display omitted] • CYB5R3 overexpression in transgenic mice induces carbon metabolism adaptations in a sex specific manner. • Skeletal muscle is an optimal model to investigate cell-autonomous, CYB5R3-dependent mechanisms of metabolic regulation. • CYB5R3 upregulates skeletal muscle markers of mitochondrial function, dynamics and biogenesis only in females. • CYB5R3 overexpression increases the size and number of intermyofibrillar mitochondria in skeletal muscle from females. • CYB5R3 overexpression is a valuable model for investigating sexual dimorphic, and potentially novel, mechanisms of aging. [ABSTRACT FROM AUTHOR]

Alternative migratory strategies can coexist within animal populations and species. Anthropogenic impacts can shift the fitness balance between these strategies leading to changes in migratory behaviors. Yet some of the mechanisms that drive such changes remain poorly understood. Here we investigate the phenotypic differences, and the energetic, behavioral, and fitness trade-offs associated with four different movement strategies (long-distance and short-distance migration, and regional and local residency) in a population of white storks (Ciconia ciconia) that has shifted its migratory behavior over the last decades, from fully long-distance migration toward year-round residency. To do this, we tracked 75 adult storks fitted with GPS/GSM loggers with tri-axial acceleration sensors over 5 years, and estimated individual displacement, behavior, and overall dynamic body acceleration, a proxy for activity-related energy expenditure. Additionally, we monitored nesting colonies to assess individual survival and breeding success. We found that long-distance migrants traveled thousands of kilometers more throughout the year, spent more energy, and >10% less time resting compared with short-distance migrants and residents. Long-distance migrants also spent on average more energy per unit of time while foraging, and less energy per unit of time while soaring. Migratory individuals also occupied their nests later than resident ones, later occupation led to later laying dates and a lower number of fledglings. However, we did not find significant differences in survival probability. Finally, we found phenotypic differences in the migratory probability, as smaller sized individuals were more likely to migrate, and they might be incurring higher energetic and fitness costs than larger ones. Our results shed light on the shifting migratory strategies in a partially migratory population and highlight the nuances of anthropogenic impacts on species behavior, fitness, and evolutionary dynamics. [ABSTRACT FROM AUTHOR]

The integration of renewable energy sources, battery banks, AC Loads, and DC Loads into standalone microgrids poses a significant challenge for energy management. This study aims to address these challenges by proposing an energy cost management model based on the online prime dual approach. The proposed model uses a real-time adaptation of PMU points, voltage range, and frequency variations to determine the energy deficit in existing standalone microgrids and battery bank charging levels. To account for energy savings, the study considers automatic scheduling of event sequences to prevent unwanted activities from being renewed every hour. The proposed model shows a significant improvement in power sharing, energy cost, and PMU controllability with response time and accuracy. The study presents the percentage of power sharing with energy costs of the proposed energy monitoring in standalone microgrids with minimal PMU locations for different expanses ranging from 20% to 90%. The cost savings of various modes can range from Rs. 5 to Rs. 7 for all expanses within a wide control range. [ABSTRACT FROM AUTHOR]

Purpose: Heart rate variability (HRV) has gained acceptance as a key marker of cardiovascular health. We compared HRV responses after continuous moderate-intensity exercise (CMIE) and high-intensity interval exercise (HIIE) matched for intensity and duration in individuals with midspectrum chronic kidney disease (CKD). Methods: Twenty men and women (age 62.0 ± 10 yrs.) diagnosed with CKD stages G3a and G3b participated in a 2 (condition) x 4 (time point) repeated cross-over measures design study. HRV time-domain indices were based on the standard deviation of all NN intervals (SDNN) and the square root of the mean of the sum of the squares of differences between adjacent NN intervals (RMSSD) and frequency domain. High-frequency (HF), low-frequency (LF), total power (TP) were examined. CMIE consisted of treadmill walking for 30 minutes at a 2% incline and speed corresponding to 60%–65% of reserve volume of oxygen (VO2R). HIIE included five intervals of 3 minutes at 90% of VO2R and 2 minutes at 20% VO2R intervals. Conditions were designed to be of the same average intensity (60% to 65% of VO2R) and caloric expenditure (~144 kcal). Results: Immediately following exercise SDNN, RMSSD, HF, LF, and TP were significantly lower compared to before exercise (p <.05). HRV responses were not different between conditions and conditions X time (p >.05). Conclusions: Thirty minutes of either CMIE or HIIE decreased HRV indices, pointing to an autonomic imbalance favoring vagal mediation. HRV's responses regarding HIIE were no different from CMIE, therefore, from an autonomic function point of view this similarity may be useful for CKD exercise prescription and programming. [ABSTRACT FROM AUTHOR]

Aim: The implementation of newborn screening programs for inborn errors of metabolism has advanced the diagnosis and management of affected infants and undoubtedly improved their outcomes. We aimed to determine out-of-pocket health expenditures of patients with inborn errors of metabolism during follow-up and treatment processes and to determine the economic burden on the families. Materials and methods: A total of 232 patients who voluntarily agreed to participate in the study and were regularly followed up in the Department of Pediatric Metabolism with the diagnosis of Inborn Errors of Metabolism between April 2022 and July 2022 were included. Questionnaires were asked about the demographic characteristics of patients, use of health services, follow-up, treatment procedures, frequency of controls and health expenditures. Results: The average out-of-pocket expenditure of the households in the last month was 1039.22 ± 1030.08 (minimum: 20, maximum: 5000) Turkish Liras. When we consider the catastrophic health expenditure rate as expenditure exceeding 40% of household income, we found that 9.9% (23 people) of parents included in the study made catastrophic health expenditures. The rate of catastrophic expenditure of patients with a diagnosis of Amino Acid Metabolism Disorders was found to be higher than that of patients with a diagnosis of Vitamin and Cofactor Metabolism Disorders. Similarly, patients with a diagnosis of lysosomal storage diseases had more expenditures than patients with a diagnosis of vitamin and cofactor metabolism disorders. When we compared the rate of catastrophic health expenditure of the patients with urea cycle disorders and the patients with a diagnosis of vitamin and cofactor metabolism disorders, the former had more expenditure than the latter (p < 0.05). There was no significant difference between other disease groups in terms of catastrophic expenditure. The rate of catastrophic expenditures of the households living as large family type were higher than the families living as nuclear family type (p < 0.01). A statistically significant difference was found between the rates of catastrophic expenditures of the families living in Ankara and those who were admitted from other provinces for follow-up and treatment (p < 0.001). However, there was no difference between the rates of catastrophic expenditure of the patients who received any treatment and those who were followed up without treatment (p > 0.05). Conclusion: Due to the high rate of consanguineous marriages in our country, the development of newborn screening programs, the increase in awareness about metabolic diseases and the improvement in diagnostic methods, the frequency of metabolic diseases is increasing, and mortality and morbidity rates are significantly reduced with early diagnosis and treatment opportunities. It is necessary to carry out more comprehensive studies to determine and prevent the socioeconomic effects of out-of-pocket health expenditures of patients living with Inborn Errors of Metabolism. [ABSTRACT FROM AUTHOR]

Objectives: To investigate first, the level, distribution, patterns and prevalence of seven-day, objectively-measured physical activity (ambulation) in a rural health and demographic surveillance system (HDSS) site in South Africa, across demographic, temporal and anthropometric measures, within a sample of adolescent and adult participants from a defined ethnic group. Second, to investigate the strength and direction of association between levels of adiposity and physical activity (ambulation). Data description: The data collected comprises anonymized, individual-level, seven-day pedometry data from a cross-sectional, conveniently sampled survey conducted in 2005–2007. The data includes daily steps and daily activity energy expenditure, basic demographic and temporal information (age, sex, village, day, season) and anthropometric measures (stature, body mass, waist and hip circumference, skinfold thickness) and resting heart rate and blood pressure. Given that this data set was of the first large-scale surveys of objectively-measured physical activity in a South African sample, it could be useful for inclusion in future ecological studies investigating the trend of physical activity over time in the South African population. In addition, this objectively-measured data could provide a useful triangulation point for the interpretation and validation of surveys conducted using self-report measures, especially within rural communities. [ABSTRACT FROM AUTHOR]

Physical activity (PA) has a substantial impact on health and mortality. Besides questionnaires that rely on subjective assessment of activity levels, accelerometers can help to objectify an individual's PA. In this study, variables estimating PA and sleep time obtained through the wGT3X-BT activity monitor (ActiGraph LLC, USA) in 797 participants of the Berlin Aging Study II (BASE-II) were analyzed. Self-reports of PA and sleep time were recorded with Rapid Assessment of Physical Activity (RAPA) and the Pittsburgh Sleep Quality Index sleep questionnaire (PSQI). Total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglycerides (TG), fasting glucose, and hemoglobin A1c (HbA1c) were determined in an accredited standard laboratory. Of all participants, 760 fulfilled the PA wear-time criteria. In this sample mean age was 75.6 years (SD: 3.8 years, range 66.0–94.1 years) and 53% of the included participants were women. Average wear time was 23.2 h/day (SD 1.3 h/day). Statistically significant differences between RAPA groups were found for all accelerometric variables except energy expenditure. Post-hoc analysis, however, suggested low agreement between subjective and device-based assessment of physical activity. TC, HDL-C, LDL-C, TG, fasting glucose and HbA1c were weakly correlated with accelerometric variables (Pearson's r ≤ 0.25). Device-based average sleep time per night (mean sleep time = 6.91 h, SD = 1.3, n = 720) and self-reported average sleep time per night (mean sleep time = 7.1 h, SD = 1.15 h, n = 410) were in a comparable range and moderately correlated (Pearson's r = 0.31, p < 0.001, n = 410). Results from this study suggest that self-reported PA obtained through the RAPA and device-based measures assessed by accelerometers are partially inconsistent in terms of the physical activity level of the participants. Self-reported and device-based measures of average sleep time per night, however, were comparable. [ABSTRACT FROM AUTHOR]

Summary: The aim of this study was to better characterise whether sleep habits, eating schedule and physical activity in real‐life are associated with glycaemic control in patients with type 2 diabetes. A total of 28 patients (aged 60 years [58; 66], 54% female) with type 2 diabetes treated with basal‐bolus insulin therapy administered by insulin pumps were analysed. Glycaemic data measured by Flash Glucose Monitor System, physical activity and sleep data measured by accelerometer, and meal schedules were simultaneously collated with insulin pump administration data, for 7 days in real‐life. Their respective impact on the time spent in target, in hypoglycaemia, in hyperglycaemia and on glycaemic variability was evaluated. Multiple regressions showed that the total daily dose of meal boluses of insulin was inversely associated with the coefficient of variation (CV; coefficient β = −0.073; 95% confidence interval: −0.130, −0.015; p = 0.016), as well as sleep duration. The higher the sleep duration, the lower the glycaemic variability (coefficient β = −0.012; 95% confidence interval: −0.023, −0.002; p = 0.027). The mean 7 days physical activity of the subjects was very low and was not associated with glycaemic control on the 7 days mean values. However, days with at least 1 hr spent in physical activity higher than 1.5 METs were associated with less glycaemic variability that same day. This real‐life observation highlights the importance of sufficient sleep duration and regular physical activity to lessen the glycaemic variability of patients with type 2 diabetes. [ABSTRACT FROM AUTHOR]

The need for energy and environmental sustainability drives the adoption of renewable energy systems to reduce greenhouse gas emissions. Efficient planning of energy sources is crucial for a reliable distribution network. This article solves the optimal allocation of hybrid energy sources (i.e., Renewable Distribution Generators (RDGs) and Battery Energy Storage System (BESS)) problem, aiming to minimize the annual energy loss and investment costs simultaneously. The proposed formulation includes the uncertainties such as forced outages of RDG's, intermittence in RDG power generation, Expected Energy Not Served (EENS) by DG units, and time-varying demand altogether in the existing formulation. To evaluate the effectiveness of the proposed formulation, a Multi-Objective Evolutionary Algorithm based on Decomposition with Dynamic Resource Allocation (MOEA/D-DRA) is used. Simulation studies are conducted on IEEE 33-node and TNEB 84-node Radial Distribution Systems (RDSs), comparing results with the Rider Optimization Algorithm (ROA) and Hybrid Nelder Mead-Particle Swarm Optimization (HNMPSO) respectively. The proposed formulation for a Multi-objective Optimization of Hybrid Energy Sources allocation problem solved by the MOEA/D-DRA algorithm provides improved benefits like minimum annual energy loss, investment cost, CO2 emission, EENS by the DG units, and enhanced system voltage stability and voltage profile. [ABSTRACT FROM AUTHOR]

Background: High-grade gliomas (HGG) account for 60–75% of all adult gliomas. The complexity of treatment, recovery and survivorship creates a need for novel monitoring approaches. Accurate assessment of physical function plays a vital role in clinical evaluation. Digital wearable tools could help us address unmet needs by offering unique advantages such as scale, cost and continuous real-world objective data. We present data from 42 patients enrolled into the BrainWear study. Methods: An AX3 accelerometer was worn by patients from diagnosis or at recurrence. Age-, sex-matched UK Biobank control groups were chosen for comparison. Results: 80% of data were categorised as high-quality demonstrating acceptability. Remote, passive monitoring identifies moderate activity reduces both during a course of radiotherapy (69 to 16 minutes/day) and at the time of progressive disease assessed by MRI (72 to 52 minutes/day). Mean acceleration (mg) and time spent walking daily (h/day) correlated positively with the global health quality of life and physical functioning scores and inversely with the fatigue score. Healthy controls walked on average 2.91h/day compared to 1.32h/day for the HGG group on weekdays and 0.91h/day on the weekend. The HGG cohort slept for longer on weekends (11.6h/day) than weekdays (11.2h/day) compared to healthy controls (8.9h/day). Conclusion: Wrist-worn accelerometers are acceptable and longitudinal studies feasible. HGG patients receiving a course of radiotherapy reduce their moderate activity by 4-fold and are at least half as active as healthy controls at baseline. Remote monitoring can provide a more informed and objective understanding of patient activity levels to help optimise health related quality of life (HRQoL) among a patient cohort with an extremely limited lifespan. [ABSTRACT FROM AUTHOR]

Introduction: Any type of activity that results in caloric expenditure has the potential to reduce the risk of cardiovascular diseases; nonetheless, most people, especially office workers, are physically inactive. This study sought to evaluate the extent of physical inactivity and its determinants among the staff of selected banks in Accra, Ghana. Methods: This was a cross-sectional study involving 219 banking staff randomly selected from five commercial banking institutions in Accra, Ghana. Demographic data was collected with a structured questionnaire. Physical inactivity was assessed using the Global Physical Activity Questionnaire. Study associations were determined using univariate analysis, and multivariate logistic regression models with adjusted odds ratio (AOR) and 95% confidence intervals (CI) estimated. Results: Two hundred and nineteen (219) participants were recruited, out of which 56.6% were males and 43.4% were females. The mean age (± SD) of the participants was 40.0±7.9 years. Physical inactivity was observed in 179 (81.7%) participants. The following were independently associated with physical inactivity: travel-related activities (AOR, 0.151; 95% CI, 0.059–0.384; p<0.001); working in the bank for 6–10 years (AOR, 4.617; 95% CI, 1.590–13.405; p = 0.005); and working in the bank for 11 years and above (AOR, 2.816; 95% CI, 1.076–7.368; p = 0.035). Conclusion: Physical inactivity was very high among bankers. Travel-related activities reduced physical inactivity whiles working at the bank for more than six years increased physical inactivity. Thus, promoting regular physical activity, frequent monitoring, and implementation of other appropriate healthy lifestyle intervention strategies are vital to reduce risk of early onset disease conditions associated with physical inactivity in this population. [ABSTRACT FROM AUTHOR]

Low back pain (LBP) is the leading cause of disability worldwide and often associated with lifestyle factors. However, studies further examining the role of these lifestyle factors in non-specific low back pain in comparison with radicular pain are sparse. The aim of this cross sectional study was to investigate how diverse lifestyle factors are associated with LBP. The study population of 3385 middle aged adults with and without low back pain was drawn from a large Birth 1966 Cohort. Outcome measures were steps per day, abdominal obesity, physical activity and endurance of the back muscles. Back static muscular endurance, abdominal obesity and physical activity were measured by means of the Biering–Sørensen test, waist circumference and a wrist worn accelerometer, respectively. Logistic regression analysis was applied to estimate associations of back static muscular endurance, abdominal obesity and accelerometer-measured physical activity with non-specific low back pain and radicular pain. An additional 1000 steps per day were associated with 4% lower odds of having non-specific low back pain. Participants with abdominal obesity had 46% higher odds of having radicular pain, whereas increases of 10 s in back static muscular endurance and 10 min in daily vigorous physical activity were associated with 5% and 7% lower odds of having radicular pain, respectively. In this population-based study, non-specific low back pain and radicular pain were associated with different lifestyle and physical factors at midlife. Non-specific low back pain was associated only with the average daily number of steps, whereas abdominal obesity was the strongest determinant of radicular pain, followed by vigorous physical activity and back static muscular endurance. The findings of this study contribute to better understand the role of lifestyle factors in both non-specific low back pain and radicular pain. Future longitudinal studies are required to explore causality. [ABSTRACT FROM AUTHOR]

Despite improving various technical indices such as operation and voltage profile, the integration of synchronous distributed generations (SDGs) may lead to the loss of protection coordination in the distribution network (DN). To tackle the problem, this paper presents a multi‐objective siting and sizing of SDGs on DN considering operation, economic and protection coordination indices simultaneously. The proposed scheme is structured in the framework of a four‐objective optimization problem, which aims to minimize the energy losses, the worst voltage security index (VSI), planning cost of SDGs and the protection index (PI) (the deviation of coordination time interval). Therefore, it is constrained to power flow equations, VSI, and protection coordination of overcurrent relays (OCRs). Then, the Pareto optimization based on the method of the weighted functions summation obtains an integrated single‐objective problem for the proposed scheme. Next, a hybrid evolutionary algorithm formed by merging particle swarm optimization (PSO) and crow search algorithm (CSA) is incorporated to achieve the optimal solution with unique response approximate conditions. Eventually, the suggested scheme is applied on distribution portion of IEEE 30‐bus ring and IEEE 69‐bus radial DN and numerical results confirm the efficient performance of SDG planning in terms of technical indicators and protective devices coordination. [ABSTRACT FROM AUTHOR]

Background: Autologous stem cell transplant is a common procedure for people with haematological malignancies. While effective at improving survival, autologous stem cell transplant recipients may have a lengthy hospital admission and experience debilitating side-effects such as fatigue, pain and deconditioning that may prolong recovery. Prehabilitation comprising exercise and nutrition intervention before stem cell transplant aims to optimise physical capacity before the procedure to enhance functional recovery after transplant. However, few studies have evaluated prehabilitation in this setting. We aim to explore preliminary efficacy of improving physical capacity of prehabilitation for people undergoing autologous stem cell transplant. Methods: The PIRATE study is a single-blinded, parallel two-armed pilot randomised trial of multidisciplinary prehabilitation delivered prior to autologous stem cell transplantation. Twenty-two patients with haematological malignancy waitlisted for transplant will be recruited from a tertiary haematology unit. The intervention will include up to 8 weeks of twice-weekly, supervised tailored exercise and fortnightly nutrition education delivered via phone, in the lead up to autologous stem cell transplant. Blinded assessments will be completed at week 13, approximately 4 weeks after transplant and health service measures collected at week 25 approximately 12 weeks after transplant. The primary outcome is to assess changes in physical capacity using the 6-minute walk test. Secondary measures are time to engraftment, C-reactive protein, physical activity (accelerometer), grip strength, health-related quality of life (EORTC QLQ-C30 and HDC29 supplement), self-efficacy and recording of adverse events. Health service data including hospital length of stay, hospital readmissions, emergency department presentations and urgent symptom clinic presentation at will also be recorded. Discussion: This trial will inform design of a future definitive randomised controlled trial and implementation of prehabilitation for people receiving autologous stem cell transplant by providing data on efficacy and safety. Trial registration: The PIRATE Trial has been approved by the Eastern Health Human Research Ethics Committee (E20/003/61055) and is funded by the Eastern Health Foundation. This trial is registered with the Australian New Zealand Clinical Trials Registry ACTRN12620000496910. Registered April 20, 2020. [ABSTRACT FROM AUTHOR]

Humans have a larger energy budget than great apes, allowing the combination of the metabolically expensive traits that define our life history. This budget is ultimately related to the cardiac output, the product of the blood pumped from the ventricle and the number of heart beats per minute, a measure of the blood available for the whole organism physiological activity. To show the relationship between cardiac output and energy expenditure in hominid evolution, we study a surrogate measure of cardiac output, the aortic root diameter, in humans and great apes. When compared to gorillas and chimpanzees, humans present an increased body mass adjusted aortic root diameter. We also use data from the literature to show that over the human lifespan, cardiac output and total energy expenditure follow almost identical trajectories, with a marked increase during the period of brain growth, and a plateau during most of the adult life. The limited variation of adjusted cardiac output with sex, age and physical activity supports the compensation model of energy expenditure in humans. Finally, we present a first study of cardiac output in the skeleton through the study of the aortic impression in the vertebral bodies of the spine. It is absent in great apes, and present in humans and Neanderthals, large-brained hominins with an extended life cycle. An increased adjusted cardiac output, underlying higher total energy expenditure, would have been a key process in human evolution. [ABSTRACT FROM AUTHOR]

Specific high physical and psychological load energy expenditure should be covered by balanced diet that is adapted to physical load. Food intake is one of the vital processes that support body activity and maintain physical working capacity in special environment. Various objective and subjective factors have an impact on body energy expenditure and determine a definite amount of food energy. Dietary intake influences the readiness and training performance outcome. The purpose of the study was to evaluate the diet of physically active persons before and after a nutritional education course and determine the impact of nutrition knowledge on nutrition behaviour and diet in two subgroups: respondents with a standard BMI level (BMI < 25, in the interval 18.5–24.9) and overweight respondents with BMI ³ 25, in the interval 25.0–29.9. Participants aged 22–35 years, who had daily physical activity and physical load, were selected for the study group. We divided respondents into two subgroups: respondents with standard BMI level (BMI < 25; BMI in the interval 18.5–24.9) and overweight respondents with BMI ³ 25 (BMI in the interval 25.0–29.9). Nutritional education course included the theoretical part (lectures) and practical part (dietary diary self-assessment) as well as a quiz that allow to evaluate nutrition knowledge level in the selected cohort of respondents with BMI < 25 and BMI ³ 25. We provided intervention before and after a nutritional education course by using the standardised questionnaire "Diet 3-day menu diary" and standardised survey "Physical activity during the current life period", which allowed to evaluate the balance between the daily intake for energy recovery and daily physical activity as energy expenditure. We determined the value of the main dietary components (protein (%), carbohydrates (%) and fat (%), as well the total amount of energy (kcal) in the diet before the nutritional education course (Diet 1st) and after the nutritional education course (Diet 2nd) in the selected cohort of respondents with BMI < 25 and BMI ³ 25. The study group participants preferred a diet with a higher amount of fat and lower amount of carbohydrates compared with nutritional recommendation for general population. There were no significant differences in Diet 1st components between overweight and standard BMI groups. Analysis of post-course (Diet 2nd) dietary diary showed a statistically exact significance of fat level (%) and carbohydrate level (%), and no statistically approved changes in protein level (%) intake. Nutritional knowledge of the study group participants after the nutritional education course was evaluated by using a standardised test in points (1–10), which showed that about 60% of the respondents received an assessment "good". The results of the study can be used to develop optimal diet planning during the pre-training period before planning physical exercises with high physical and psycho-emotional load, in order to benefit physical exercise performance. [ABSTRACT FROM AUTHOR]

Summary: Accelerometers placed on the thigh provide accurate measures of daily physical activity types, postures and sedentary behaviours, over 24 h and across consecutive days. However, the ability to estimate sleep duration or quality from thigh‐worn accelerometers is uncertain and has not been evaluated in comparison with the 'gold‐standard' measurement of sleep polysomnography. This study aimed to develop an algorithm for sleep estimation using the raw data from a thigh‐worn accelerometer and to evaluate it in comparison with polysomnography. The algorithm was developed and optimised on a dataset consisting of 23 single‐night polysomnography recordings, collected in a laboratory, from 15 asymptomatic adults. This optimised algorithm was then applied to a separate evaluation dataset, in which, 71 adult males (mean [SD] age 57 [11] years, height 181 [6] cm, weight 82 [13] kg) wore ambulatory polysomnography equipment and a thigh‐worn accelerometer, simultaneously, whilst sleeping at home. Compared with polysomnography, the algorithm had a sensitivity of 0.84 and a specificity of 0.55 when estimating sleep periods. Sleep intervals were underestimated by 21 min (130 min, Limits of Agreement Range [LoAR]). Total sleep time was underestimated by 32 min (233 min LoAR). Our results evaluate the performance of a new algorithm for estimating sleep and outline the limitations. Based on these results, we conclude that a single device can provide estimates of the sleep interval and total sleep time with sufficient accuracy for the measurement of daily physical activity, sedentary behaviour, and sleep, on a group level in free‐living settings. [ABSTRACT FROM AUTHOR]

Most companies survive the pain of cost and schedule overruns because of inaccurate project activity time settings. In order to deliver a project with a target cost and on schedule, this research proposes an inverse optimal value approach to optimize activity durations and the corresponding worker assignments synchronously to make the optimal project cost infinitely close to an ideal cost. The leader model reflects cost orientation and adjustability of activity durations, the follower model reflects the complexity of activity sequence, critical path completion time, cost pressure, skill matching, energy consumption, and other costs. Through upper-level and lower-level feedback and interaction of activity durations and worker assignments it is possible to deliver a project with an ideal cost. With considerations of the mathematical model characteristics of bi-level programming, nonlinearity, NP hard, and MAX functions, an improved genetic algorithm combining adaptive artificial fish swarms is designed. From the comparison results of random examples and an actual example, the error rate of the optimal value of the improved algorithm is acceptable. Numerical experiments show that the inverse optimal approach can deliver a project without delay and with an ideal cost. The inverse optimization method is more in line with the idea of target management, and can help managers achieve the purpose of cost control. [ABSTRACT FROM AUTHOR]

Background: Low carbohydrate high fat (LCHF) diet has been a popular low carbohydrate diet in Sweden for 15 years. Many people choose LCHF to lose weight or control diabetes, but there are concerns about the effect on long-term cardiovascular risks. There is little data on how a LCHF diet is composed in real-life. The aim of this study was to evaluate the dietary intake in a population with self-reported adherence to a LCHF diet. Methods: A cross-sectional study of 100 volunteers that considered themselves eating LCHF was conducted. Diet history interviews (DHIs) and physical activity monitoring for validation of the DHIs were performed. Results: The validation shows acceptable agreement of measured energy expenditure and reported energy intake. Median carbohydrate intake was 8.7 E% and 63% reported carbohydrate intake at potentially ketogenic levels. Median protein intake was 16.9 E%. The main source of energy was dietary fats (72.0 E%). Intake of saturated fat was 32 E% and cholesterol was 700 mg per day, both of which exceeded the recommended upper limits according to nutritional guidelines. Intake of dietary fiber was very low in our population. The use of dietary supplements was high, and it was more common to exceed the recommended upper limits of micronutrients than to have an intake below the lower limits. Conclusions: Our study indicates that in a well-motivated population, a diet with very low carbohydrate intake can be sustained over time and without apparent risk of deficiencies. High intake of saturated fats and cholesterol as well as low intake of dietary fiber remains a concern. [ABSTRACT FROM AUTHOR]

Seasonal migrations are used by diverse animal taxa, yet the costs and benefits of migrating have rarely been empirically examined. The aim of this study was to determine how migration influences two ecological currencies, energy expenditure and time allocated towards different behaviors, in a full annual cycle context. We compare these currencies among lesser black-backed gulls that range from short- (< 250 km) to long-distance (> 4500 km) migrants. Daily time-activity budgets were reconstructed from tri-axial acceleration and GPS, which, in conjunction with a bioenergetics model to estimate thermoregulatory costs, enabled us to estimate daily energy expenditure throughout the year. We found that migration strategy had no effect on annual energy expenditure, however, energy expenditure through time deviated more from the annual average as migration distance increased. Patterns in time-activity budgets were similar across strategies, suggesting migration strategy does not limit behavioral adjustments required for other annual cycle stages (breeding, molt, wintering). Variation among individuals using the same strategy was high, suggesting that daily behavioral decisions (e.g. foraging strategy) contribute more towards energy expenditure than an individual's migration strategy. These findings provide unprecedented new understanding regarding the relative importance of fine versus broad-scale behavioral strategies towards annual energy expenditures. [ABSTRACT FROM AUTHOR]

Objective: We report our experience with a validated waist-worn activity monitor in Jamaican adolescents attending urban high schools. Seventy-nine adolescents from the Global Diet and Activity Research (GDAR) study, recruited from 5 urban Jamaican high schools (two coeducational (n = 37), two all-female schools (n = 32) and one all-boys school (n = 10)) were asked to wear Actigraph wGT3X-BT accelerometers for 7 days (24-h), removing the device only when bathing or swimming. They also logged wake up and bed times in an activity diary. Accelerometry was considered valid if at least 4 days with ≥ 10-h monitor wear were recorded. Validity was compared by adolescent demographic and school characteristics. We also reviewed the students' written feedback on objective physical activity measurement. Results: Participants, 80.5% female, had a mean age of 15.5 ± 0.8 years with 60% attending schools in low-income communities. Accelerometer return rates were > 98% with 84% providing valid data. Validity did not vary by age group, sex and school setting. While participants were excited about participating in the accelerometer sub-study, commonly reported challenges included monitor discomfort during sleep and maintaining the study diary. Objective measurement of physical activity using 24-h waist-worn accelerometers is feasible and acceptable in Jamaican adolescents. [ABSTRACT FROM AUTHOR]

Fatty acid translocase/cluster of differentiation 36 (FAT/CD36) is a multifunctional membrane protein activated by a high-fat diet, physical exercise, fatty acids (FAs), leptin, and insulin. The principal function of FAT/CD36 is to facilitate the transport of long-chain fatty acids through cell membranes such as myocytes, adipocytes, heart, and liver. Under high-energy expenditure, the different isoforms of FAT/CD36 in the plasma membrane and mitochondria bind to the mobilization and oxidation of FAs. Furthermore, FAT/CD36 is released in its soluble form and becomes a marker of metabolic dysfunction. Studies with healthy animals and humans show that physical exercise and a high-lipid diet increase FAT/CD36 expression and caloric expenditure. However, several aspects such as obesity, diabetes, Single Nucleotide polymorphisms (SNPs), and oxidative stress affect the normal FAs metabolism and function of FAT/CD36, inducing metabolic disease. Through a comprehensive systematic review of primary studies, this work aimed to document molecular mechanisms related to FAT/CD36 in FAs oxidation and trafficking in skeletal muscle under basal conditions, physical exercise, and diet in healthy individuals. [ABSTRACT FROM AUTHOR]

Background: Unilateral vestibular hypofunction (UVH) may lead to modifications on metabolism and body composition. Vestibular rehabilitation (VR) demonstrated its effectiveness in ameliorating balance function and several other daily-living aspects. Objectives: The aim of this study was to evaluate metabolic composition, by means of bioelectrical impedance analysis (BIA) and daily activity, with the use of a wrist-worn movement tracker, in UVH participants before and after VR, and to compare data with a healthy control group (CG) of adults. Methods: 46 UVH and 60 CG participants underwent otoneurological testing, self-report and performance questionnaires, BIA, and wore a device tracking daily movement and energy expenditure for one full day; this was performed before and after VR. Results: UVH participants demonstrated a significant (p = 0.008) increase in muscle mass after VR, and, when compared to CG, no differences were present with respect to visceral fat and muscle mass. UVH adults reported a significant increase in energy expenditure spent in movement (p = 0.008) and during the day (p = 0.009), daily number of strides (p = 0.009) and calories spent in sweeping (p = 0.009) and stairing (p = 0.008). Conclusions: Results from this study show that VR provided an improvement of metabolic function and body composition of people with UVH, possibly by contrasting structural modifications in neural pathways stemming from the vestibular nuclei and connected to autonomous function. [ABSTRACT FROM AUTHOR]

This study aims to create a comprehensive, holistic approach to evaluate the environmental, energy, and economic impacts of air source heat pump deployment scenarios through: (i) a life cycle assessment of air source heat pumps in Orkney houses, (ii) energy systems optimisation modelling to optimise the performance of an air source heat pump coupled with thermal energy storage tank to reduce use phase related impacts in Orkney, (iii) modelling of Orkney's domestic building stock to understand the housing condition, and (iv) economic modelling to analyse the life cycle cost of an air source heat pump and potential savings when replacing conventional heating systems. The results show that an 82% reduction in energy supply could be achieved when ambitious energy efficiency improvement measures are adopted in the circular economy scenario. The use phase related emissions could be reduced by 98% when the air source heat pump becomes the only heating technology in Orkney. However, the life cycle-wide approach suggests that strong commitments are required in the manufacturing stage of these technologies through implementing circular principles, such as including the use of secondary materials, eco-design, and reusability of all components. Moreover, total heating costs paid by consumers in Orkney could be reduced by 84% in the circular economy scenario when air source heat pump uptake is coupled with energy efficiency improvement measures, but it requires a £130 million investment to insulate the whole housing stock of Orkney. Future scenarios indicate that decision-making has significant importance on overall results. Therefore, circular economy standards for air source heat pump manufacturing and deployment are crucial to reduce the negative impacts of fuel poverty and reach the net zero target. [ABSTRACT FROM AUTHOR]

Simple Summary: Self-efficacy has been identified as a crucial variable to reduce sedentarism in women with fibromyalgia. The present study aimed to evaluate the role of self-efficacy, the impact of fibromyalgia, and activity patterns on the objective physical activity levels. One hundred and twenty-three women with fibromyalgia participated in this cross-sectional study. Physical activity levels were assessed with accelerometers, while self-efficacy, activity patterns, and fibromyalgia impact were evaluated through questionnaires. Results revealed that self-efficacy for physical activity was directly related to light, moderate, and vigorous physical activity, as well as inversely related to sedentary time. Self-efficacy for walking and light physical activity seems to be more relevant than self-efficacy for moderate and vigorous physical activity to achieve higher levels of physical activity. Keeping high levels of physical activity is a challenge among chronic patients. In this regard, self-efficacy has been identified as a crucial variable to reduce sedentarism and physical inactivity in women with fibromyalgia. The current study aimed to evaluate the associations among objective physical activity levels, self-efficacy, activity patterns, and the impact of the disease, as well as to compare those variables between women with fibromyalgia with different self-efficacy levels. For this purpose, in this cross-sectional study, the physical activity levels of 123 women with fibromyalgia were assessed by accelerometers, together with self-efficacy, the impact of the disease, and activity patterns. Results revealed that self-efficacy for light or moderate physical activity was directly related to light (p < 0.01), moderate (p < 0.01), and vigorous physical activity (p < 0.05), as well as inversely related to sedentary time (p < 0.01). Moreover, the main differences were observed between those with low self-efficacy levels and the rest of the sample, while there were no differences between the high and the medium self-efficacy groups (p > 0.05). Thus, self-efficacy for walking and light physical activity seems to be more relevant than self-efficacy for moderate and vigorous physical activity to achieve higher levels of physical activity. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to describe a methodological procedure to quantify the heat production (HP) partitioning in basal metabolism or fasting heat production (FHP), heat production due to physical activity (HPA), and the thermic effect of feeding (TEF) in roosters. Methods: Eighteen 54-wk-old Hy Line Brown roosters (2.916±0.15 kg) were allocated in an open-circuit chamber of respirometry for O2 consumption (VO2), CO2 production (VCO2), and physical activity (PA) measurements, under environmental comfort conditions, following the protocol: adaptation (3 d), ad libitum feeding (1 d), and fasting conditions (1 d). The Brouwer equation was used to calculate the HP from VO2 and VCO2. The plateau-FHP (parameter L) was estimated through the broken line model: HP = U×(R–t)×I+L; I = 1 if tR; Where the broken-point (R) was assigned as the time (t) that defined the difference between a short and long fasting period, I is conditional, and U is the decreasing rate after the feed was withdrawn. The HP components description was characterized by three events: ad libitum feeding and short and long fasting periods. Linear regression was adjusted between physical activity (PA) and HP to determine the HPA and to estimate the standardized FHP (st-FHP) as the intercept of PA = 0. Results: The time when plateau-FHP was reached at 11.7 h after withdrawal feed, with a mean value of 386 kJ/kg0.75/d, differing in 32 kJ from st-FHP (354 kJ/kg0.75/d). The slope of HP per unit of PA was 4.52 kJ/mV. The total HP in roosters partitioned into the st-FHP, termal effect of feeding (TEF), and HPA was 56.6%, 25.7%, and 17.7%, respectively. Conclusion: The FHP represents the largest fraction of energy expenditure in roosters, followed by the TEF. Furthermore, the PA increased the variation of HP measurements. [ABSTRACT FROM AUTHOR]

The health of animal populations can reflect ongoing changes in their environment. Various physiological parameters can be used to assess individual and population conditions. These parameters may be interrelated or independent, allowing for organisms to respond flexibly to environmental changes. We investigated the dynamics of the leukocyte profile (total number and relative proportions of various types of leukocytes) in an urban population of the Great tit (Parus major) during two stages of the annual cycle: autumn migration and wintering. We also analyzed the relations between the leukocyte profile and the energy state, hematocrit, and the levels of blood metabolites (glucose and β-hydroxybutyrate). We found the total number of leukocytes and lymphocytes to be higher during autumn migration compared to wintering, which indicates a more active state of the immune system in Great tits during migration. An increased number of lymphocytes (specific immunity) can reflect high probability of encountering already familiar infections during the relatively short-distance migrations typical for this species. The ratio of heterophils to lymphocytes (H : L ratio, a measure of long-term physiological stress) in this population was higher in winter than during autumn migration. We assume that this may be caused by low temperatures and increased competition for food in wintering birds. The total number of leukocytes correlated positively with energy reserves and negatively with the blood glucose level, possibly indicating a coordinated response of these physiological parameters to environmental cues. Our results also show that birds that have adequate energy reserves and low blood glucose concentrations (i.e., are in good condition) maintain a more active immune system. Reduced energy reserves (e.g., due to unfavorable feeding conditions, higher energy costs of both locomotor activity and thermogenesis in cold weather) caused an increase in blood glucose concentrations and a decrease in the number of leukocytes. The H : L ratio was not correlated with other physiological parameters, showing that the level of long-term physiological stress was related to neither the individual energetic condition nor the level of metabolism in Great tits under the observed environmental conditions. Taken together, our results show a low level of long-term physiological stress in the studied population of Great tits. [ABSTRACT FROM AUTHOR]

Falls are a critical public health issue among older adults. One notable factor contributing to falls in older adults is a deterioration of the structures supporting balance and overall balance control. Preliminary evidence suggests older adults who ride a bicycle have better balance than those who do not. Cycling may be an effective intervention to prevent falls among older adults. This study aims to objectively measure the relationship between bicycling, physical activity, and balance for older adults. Older adult cyclists (n = 19) and non-cyclists (n = 27) were recruited to (1) complete a survey that assessed demographics; (2) wear an accelerometer for 3 weeks to objectively assess physical activity; and (3) complete balance-related tasks on force platforms. Mann-Whitney U-tests were performed to detect differences in balance and physical activity metrics between cyclists and non-cyclists. Cyclists were significantly more physically active than non-cyclists. Cyclists, compared to non-cyclists, exhibited differences in balance-related temporospatial metrics and long-range temporal correlations that suggest a more tightly regulated postural control strategy that may relate to higher stability. Cycling was observed to correlate more strongly with balance outcomes than other physical activity. Taken together, these results demonstrate the possible implications for cycling as an effective intervention to improve balance and reduce fall risk. [ABSTRACT FROM AUTHOR]

Background and Objectives: It is often difficult to assess the nutritional requirements of severely injured patients. In this study, we aimed to determine whether various nutritional assessment formulas are accurate at assessing the nutritional requirements of trauma patients. Methods and Study Design: We recruited trauma patients who were admitted to a trauma centre in 2018 and were identified as being at high risk for malnutrition. Energy expenditure was calculated using commonly used prediction equations, and the results were compared to resting energy expenditures measured using indirect calorimetry. Results: Sixty-nine patients (78.9% men; mean age, 53.6 years) collectively underwent 95 indirect calorimetry assessments. The average resting energy expenditure was 1761.8±483.8 kcal/day, and the average respiratory quotient was 0.8±0.2. The correlations between the measured resting energy expenditures and nutritional requirements estimated by each formula were significant but weak (i.e., r-values <0.8). The Penn State formula had the highest r-value (0.742; 95% confidence interval [CI], 0.6359-0.8210), followed by the Faisy formula (0.730; 95% CI, 0.620-0.812). Conclusions: The formulapredicted nutritional requirements did not adequately correlate with the resting energy expenditures measured by indirect calorimetry. Therefore, we recommend using indirect calorimetry to assess the nutritional requirements of severely injured patients. [ABSTRACT FROM AUTHOR]

Predictive simulation of human walking has great potential in clinical motion analysis and rehabilitation engineering assessment, but large computational cost and reliance on measurement data to provide initial guess have limited its wide use. We developed a computationally efficient model combining optimization and inverse dynamics to predict three-dimensional whole-body motions and forces during human walking without relying on measurement data. Using the model, we explored two different optimization objectives, mechanical energy expenditure and the time integral of normalized joint torque. Of the two criteria, the sum of the time integrals of the normalized joint torques produced a more realistic walking gait. The reason for this difference is that most of the mechanical energy expenditure is in the sagittal plane (based on measurement data) and this leads to difficulty in prediction in the other two planes. We conclude that mechanical energy may only account for part of the complex performance criteria driving human walking in three dimensions. [ABSTRACT FROM AUTHOR]

INTRODUCTION: The unified medical prescription was implemented as a policy to decrease the overall health expenditures and increase the use of generic drugs. The main objective of this study was to evaluate the perception of Lebanese physicians towards the unified medical Prescription and its impact on the overall generic prescription. Additionally, an overview was assessed concerning the type of drugs that physicians tend more to accept to be substituted to generic alternatives. METHODS: A cross-sectional descriptive study was conducted in Lebanon over a period of three months targeting physicians in their private clinics or in various hospitals using a survey as an instrument. RESULTS: Our findings demonstrated that more than the half of respondents (56.6%) believed that the unified medical prescription preserves the exclusivity for physicians to choose the medication while only 39.5% of physicians think that the unified medical prescription encouraged generic prescription and almost 42% admitted that the unified medical prescription lowers the medical cost for the patient. DISCUSSION: Despite that this new medical form of prescription is a high achievement for the Lebanese Ministry Of Public Health, this last should make essential actions: coordinating the generic drug substitution policy and monitoring its implementation over time and achievement of goals; establishing appropriate pricing system and medicines prices and controlling the interactions between physicians, pharmacists, and pharmaceutical industries; ensure their full commitment; and update the national list of substitutable generic drugs. CONCLUSION: The main objective of the unified medical prescription is to decrease the pharmaceutical expenditure and to provide access to medications for patients with lower socio-economic status. Lebanese physicians reported that this tool did not achieve its goal yet but have an impact on lowering the medical cost for patients and promoting generic prescription. [ABSTRACT FROM AUTHOR]

This systematic review aims to summarize the effects of wearing different types of wetsuits and swimsuits in front crawl swimming performance and physiological- and biomechanical-related variables. The Web of Science, PubMed, Scopus and the Proceedings of the International Symposium on Biomechanics and Medicine in Swimming databases were searched from inception to 25th March 2022. From the 1398 studies initially found, 26 studies were included in the review. The quality assessment and inter-rater reliability between researchers were conducted. The full body was the most studied wetsuit, with its use allowing 3.2–12.9% velocity increments in distances ranging from 25 to 1500 m, in incremental tests, in 5 and 30 min continuous swimming and in open water events. The sleeveless long vs. the full-body wetsuit led to a 400–800 m performance enhancement. Higher stroke rate, stroke length and stroke index were observed while using three different covered body part wetsuits vs. a regular swimsuit, with a lower energy cost being observed when swimming with the full-body wetsuit compared to a swimsuit. These findings provide useful information for coaches, swimmers and triathletes about the full-body and sleeveless long/short wetsuit use, since these three wetsuits allow improving swimming performance in different distances in diverse aquatic environments. [ABSTRACT FROM AUTHOR]

Perhaps the most unexpected development in pediatric endocrinology in the past 50 years has been the recognition of obesity as an endocrine/metabolic disorder rather than a life choice or moral failing. The history of obesity research is disjointed, having followed two separate paths in the 20th century, based on two independent yet overlapping paradigms. Proponents of the "Energy Storage" hypothesis point to data implicating monogenetic disorders, the ventromedial hypothalamus, insulin, cortisol, and the adipocyte itself in the pathogenesis of obesity. Alternatively, proponents of the "Energy Balance" hypothesis point to data implicating increased caloric intake, decreased caloric expenditure, gastrointestinal hormones, and microbiome changes as being critical for obesity. These two separate lines of research merged somewhat with the discovery of leptin in 1994, as leptin established a major hormonal role in weight control. Leptin has explained some of the dichotomy and has proved essential in understanding the importance of developmental programming and epigenetics. However, the mystery of leptin resistance remains unsolved. Despite all our collective knowledge, we appear no closer in solving the obesity puzzle today than we were 50 years ago. [ABSTRACT FROM AUTHOR]

Background: The use of minimally invasive biomarkers (MIBs – physiological biomarkers obtained from minimally invasive sample types) has expanded rapidly in science and medicine over the past several decades. The MIB approach is a methodological strength in the field of human and non‐human primate evolutionary biology (HEB). Among humans and our closest relatives, MIBs provide unique opportunities to document phenotypic variation and to operationalize evolutionary hypotheses. Aims: This paper overviews the use of MIBs in HEB. Our objectives are to (1) highlight key research topics which successfully implement MIBs, (2) identify promising yet under‐investigated areas of MIB application, and (3) discuss current challenges in MIB research, with suggestions for advancing the field. Discussion and Conclusions: A range of MIBs are used to investigate focal topics in HEB, including energetics and life history variation/evolution, developmental plasticity, and social status and dominance relationships. Nonetheless, we identify gaps in existing MIB research on traits such as physical growth and gut function that are central to the field. Several challenges remain for HEB research using MIBs, including the need for additional biomarkers and methods of assessment, robust validations, and approaches that are standardized across labs and research groups. Importantly, researchers must provide better support for adaptation and fitness effects in hypothesis testing (e.g., by obtaining complementary measures of energy expenditure, demonstrating redundancy of function, and performing lifetime/longitudinal analyses). We point to continued progress in the use of MIBs in HEB to better understand the past, present, and future of humans and our closest primate relatives. [ABSTRACT FROM AUTHOR]

Wearable accelerometers record physical activity with high resolution, potentially capturing the rich details of behaviour changes and habits. Detecting these changes as they emerge is valuable information for any strategy that promotes physical activity and teaches healthy behaviours or habits. Indeed, this offers the opportunity to provide timely feedback and to tailor programmes to each participant's needs, thus helping to promote the adherence to and the effectiveness of the intervention. This article presents and illustrates U-BEHAVED, an unsupervised algorithm that periodically scans step data streamed from activity trackers to detect physical activity behaviour changes to assess whether they may become habitual patterns. Using rolling time windows, current behaviours are compared with recent previous ones, identifying any significant change. If sustained over time, these new behaviours are classified as potentially new habits. We validated this detection algorithm using a physical activity tracker step dataset (N = 12,798) from 79 users. The algorithm detected 80% of behaviour changes of at least 400 steps within the same hour in users with low variability in physical activity, and of 1600 steps in those with high variability. Based on a threshold cadence of approximately 100 steps per minute for standard walking pace, this number of steps would suggest approximately 4 and 16 min of physical activity at moderate-to-vigorous intensity, respectively. The detection rate for new habits was 80% with a minimum threshold of 500 or 1600 steps within the same hour in users with low or high variability, respectively. [ABSTRACT FROM AUTHOR]