Search

Introduction: Micro ribonucleic acids (miRNA) respond to acute bouts of vigorous exercise, such as maximal cardiopulmonary exercise tests (CPET), by expressing an anti-atherogenic, anti-inflammatory and hence probably ergogenic profile. However, the impact of long-term engagement in physical exercise on CPET-induced miRNA response in sedentary individuals, with subsequent increased risk for cardiovascular diseases, remains unclear. Methods: Thirty-four sedentary participants underwent CPET before and after a four-month app-assisted exercise intervention, during which the moderate to vigorous physical activity (MVPA) was increased to over 150 min/week. Capillary blood samples were collected before and after CPET at baseline and after the exercise intervention. Twenty target miRNAs previously reported to be responsive to exercise and exercise adaptive pathways, or linked to atherogenic properties as inflammation, or previously identified upregulated following exercise in subjects with coronary artery disease versus healthy subjects were analyzed via real-time polymerase chain reaction. Results: Physical activity increased from 64 ± 48 to 354 ± 332 min/week of MVPA (p<0.001, +553%), accompanied by an improvement in maximal power output during CPET (ΔWattmax: 19 ± 13, p<0.001, +9%). Eleven of the selected twenty miRNAs showed significant responses to CPETs at either the beginning or end of the study. We found a significant increase both times for miR-103a (glycolysis, %change base: +12%, post +17%), miR-146a (inflammation, %change base: +20%, post +21%), and miR-222 (cardiac remodeling, %change base: +10%, post +21%), while miR-30a (inflammation, %change base: -27%, post: -38%) decreased significantly (all p≤0.043). Conclusion: Increased physical activity led to a significant CPET-induced change in three miRNAs from an atherogenic profile to a healthier one, indicating improved metabolic health and reduced inflammation. [ABSTRACT FROM AUTHOR]

Background: Shared decision making (SDM) between healthcare professionals and persons with CVD can have a positive impact on motivation, adherence, or sustainability regarding long-term goals and integration of cardiovascular disease (CVD) rehabilitation in the everyday lives of persons with CVD. SDM can foster the transition between regular heart-healthy activity at rehabilitation facilities and more independent activity at home, but it is often challenging to implement SDM given limited time and resources, e.g., in the daily practice of rehabilitation. Digital tools can help but must be appropriately tailored for situated use and user needs. Objective: We aimed to (1) describe in how far SDM is manifested in the situated context when using a digital tool developed by our group, and, based on that, (2) reflect on how digital health tools can be designed to facilitate and improve the SDM process. Methods: In the context of a field study, we investigated how SDM is already naturally applied and manifested when using a digital tool for joint physical activity planning in cardiac rehabilitation in clinical practice. In a two-week qualitative study, we collected data on expectations, experiences and interactions during the use of a digital health tool by seven persons with CVD and five healthcare professionals. Data was collected by means of observations, interviews, questionnaires and a self-reported diary, and analysed with a particular focus on episodes related to SDM. Results: We found that SDM was manifested in the situated context to limited extent. For example, we identified high improvement potential for more structured goalsetting and more explicit consideration of preferences and routines. Based on mapping our findings to temporal phases where SDM can be adopted, we highlight implications for design to further support SDM in clinical practice. We consider this as “SDM supportive design in digital health apps,” suggesting for example step-by-step guidance to be used during the actual consultation. Conclusion: This study contributes to further understanding and integration of SDM in digital health tools with a focus on rehabilitation, to empower and support both persons with CVD and healthcare professionals. [ABSTRACT FROM AUTHOR]

Objective: To determine if supervised training, after the completion of cardiac rehabilitation program, performed for a further two years would help maintain beneficial effects achieved during prolonged outpatient cardiac rehabilitation. Design: Longitudinal parallel-grouped intervention study. Subjects: Patients with coronary artery disease (n = 41, age 59.5 ± 9.3 years), who finished cardiac rehabilitation phase III in our outpatient cardiac rehabilitation facility. Intervention: Two years of supervised exercise training consisting of endurance (either high intensity interval training or pyramid training) and resistance training sessions once a week. Main measurement: Peak physical work capacity was assessed via an ergometry testing at the beginning and at the end of the study. Results: Comparisons between end-of-cardiac rehabilitation and two years post cardiac rehabilitation revealed maintenance of peak physical work capacity after two years (begin vs end: 170 ± 59 W vs 167 ± 60 W; −0.5 ± 12.8%; p = 0.521). This was independent of exercise training protocols (percent change begin vs end: pyramid: 1.5 ± 11.8%; interval: −1.6 ± 13.4%; p = 0.459). Conclusion: Improvement of physical exercise capacity gained during outpatient cardiac rehabilitation can be maintained for up to two years by once-weekly supervised exercise training. Long-term, group-based exercise programs offered at the end of cardiac rehabilitation might be an effective tool to help patients maintain their physical work capacity. [ABSTRACT FROM AUTHOR]

CspA and four other small proteins with DNA- and RNA-binding sites constitute the family of dimeric major cold shock protein homologs in the psychrotrophic Bacillus cereus WSBC 10201. The amino acid sequences of the proteins are similar to each other, other prokaryotic cold shock proteins and the cold shock region of Y-box proteins. The CspA and CspE proteins are recovered as dimers with a molecular mass of 15 kDa by gel filtration. The proteins dissociate into their monomers at high salt levels. CspA shows strong expression during growth at low temperature and after cold shock.

Functional impairment caused by chronic obstructive pulmonary disease (COPD) impacts on activities of daily living and quality of life. Indeed, patients' submaximal exercise capacity is of crucial importance. It was the aim of this study to investigate the effects of an exercise training intervention with and without supplemental oxygen on submaximal exercise performance. This is a secondary analysis of a randomized, controlled, double‐blind, crossover trial. 29 COPD patients (63.5 ± 5.9 years; FEV1 46.4 ± 8.6%) completed two consecutive 6‐week periods of high‐intensity interval cycling and strength training, which was performed three times/week with either supplemental oxygen or medical air (10 L/min). Submaximal exercise capacity as well as the cardiocirculatory, ventilatory, and metabolic response were evaluated at isotime (point of termination in the shortest cardiopulmonary exercise test), at physical work capacity at 110 bpm of heart rate (PWC 110), at the anaerobic threshold (AT), and at the lactate‐2 mmol/L threshold. After 12 weeks of exercise training, patients improved in exercise tolerance, shown by decreased cardiocirculatory (heart rate, blood pressure) and metabolic (respiratory exchange ratio, lactate) effort at isotime; ventilatory response was not affected. Submaximal exercise capacity was improved at PWC 110, AT and the lactate‐2 mmol/L threshold, respectively. Although supplemental oxygen seems to affect patients' work rate at AT and the lactate‐2 mmol/L threshold, no other significant effects were found. The improved submaximal exercise capacity and tolerance might counteract patients' functional impairment. Although cardiovascular and metabolic training adaptations were shown, ventilatory efficiency remained essentially unchanged. The impact of supplemental oxygen seems less important on submaximal training effects. [ABSTRACT FROM AUTHOR]

Copyright of Juristische Blätter is the property of Verlag Oesterreich GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)