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INTRODUCTION: Each year thousands of pilots are required to undergo neuropsychological evaluation, often due to a history of alcoholism (HIMS), CVA, TBI, MCI, SSRI use, or ADHD. Of these pilots, it is estimated 18 to over 30% are found to have some form of impairment that grounds them indefinitely. METHOD: An online, coached, fee-based cognitive training (CTr) program was examined in 192 pilots residing across the United States, following identified deficiencies by their HIMS neuropsychologist (NP). The 6 to 8 week CTr program included customized assembly of exercises with weekly management and feedback by a trained instructor via email; no exercises resembled presenting stimuli found in NP tests; no office visits were made. Target Training Levels (TTL's) were developed to identify pilots who were likely to be found normal upon follow-up NP re-evaluation (NPRe), using composite z-scores from proprietary training data (PTD) and an online aviator cognitive assessment battery (OA Assess). RESULTS: Of 77 pilots reporting NPRe results, 74% passed. One-way MANOVA indicated final PTD and OA Assess scores significantly predicted NPre results [F(1,30)=4.97, p=.014; Wilks Λ=.746)]; significance was lost when pre-training baseline OA Assess scores were used (p=.053). Posttraining PTD and OA Assess cut-off scores to establish TTL's were best fit at z=.77 and z=1.46 above non-aviator means, respectively. Logistic regression indicated combined PTD and OA Assess scores best predicted whether or not a pilot would pass NPRe, with 87% accuracy [df (30) Δχ²=5.67, p=.017). Chi-square analyses indicated pilots who reached combined TTL's had an 88% chance of passing their NPRe, while those that did not reach TTL's had a 33% chance of passing (χ²=7.41, p=.006); the OA Assess TTL alone was less robust but still acceptable (p=.024). DISCUSSION: Structured, coached CTr is an effective online-based intervention for use in pilots with neurocognitive defi ciency. In addition to strengthening abilities important to flight performance and safety, the program reliably and accurately predicted which pilots would likely succeed in passing far more expensive neuropsychological evaluations, which could reduce personal and organizational costs while hastening return to duty or training. Past CTr studies showed lasting effects and in the aviation environment CTr appears far more appropriate than neurofeedback, direct electrical stimulation, and traditional cognitive rehabilitation. Learning Objectives 1. Participants will become aware of the need for non-invasive, easily accessible neurocognitive interventions in pilots with known or suspected declines in mental sharpness or abilities. 2. Participants will identify components of online CTr important to a pilot's success. 3. Participants will understand the potential to strengthen cognitive functions in a reliable, long-lasting way that generalizes to neurocognitive testing and daily activities alike. [ABSTRACT FROM AUTHOR]

Introduction and aim: Non-alcoholic fatty liver disease (NAFLD) is one of the most common diseases in the United States. Metabolic distress (obese diabetes) is the main causative element of NAFLD. While there is no cure for NAFLD, endurance exercise (EEx) has emerged as a therapeutic strategy against NAFLD. However, mechanisms of EXE-induced hepatic protection especially in female subjects remain unidentified. Thus, the aim of the study is to examine molecular mechanisms of EXE-induced hepatic protection against dietinduced NAFLD in female mice. Material and methods: Nine-week-old female C57BL/6J mice were randomly divided into three groups: normal-diet control group (CON, n=11); high-fat diet/high-fructose group (HFD/HF, n=11); and HFD/HF+EEx group (HFD/HF+EEx, n=11). The mice assigned to HFD/HF and HFD/HF+EEx groups were fed with HFD/HF for 12 weeks, after which the mice assigned to the EEx group began treadmill exercise for 12 weeks, with HFD/HF continued. Results: EEx attenuated hepatic steatosis, reduced de novo lipogenesis (reduction in ATP-Citrate-Lyase and diacylglycerol-O-acyltransferase 1), and enhanced mitochondrial biogenesis and fatty-acid activation (oxidative phosphorylation enzymes and Acyl-CoA synthetase1). Also, EEx prevented upregulation of gluconeogenic proteins (glyceraldehyde-3-phosphate dehydrogenase, glucose-6-phosphatase, and phosphoenolpyruvatecarboxykinase1), premature senescence (suppression of p53, p22, and p16, tumor-necrosis-factor-a, and interleukin-1b, and oxidative stress), and autophagy deficiency. Furthermore, EXE reversed apoptosis arrest (cleaved cysteine-dependent-aspartate-directed protease3 and Poly-(ADP-ribose)-polymerase1). Conclusion: EEx-mediated reparations of metabolic and redox imbalance (utilization of pentose phosphate pathway), and autophagy deficiency caused by metabolic distress critically contribute to preventing/delaying severe progression of NAFLD. Also, EEx-induced anti-senescence and cell turnover are crucial protective mechanisms against NAFLD. [ABSTRACT FROM AUTHOR]

Stroke remains a leading cause of death and disability in the United States. No current treatments exist to promote cognitive recovery in survivors of stroke. A previous study from our laboratory determined that an acute bout of forced treadmill exercise was able to promote cognitive recovery in 3 month old male rats after middle cerebral artery occlusion (MCAo). In this study, we tested the hypothesis that 6 days of intense acute bout of forced treadmill exercise (physical exercise – PE) promotes cognitive recovery in 11–14 month old male rats. We determined that PE was able to ameliorate cognitive deficits as determined by contextual fear conditioning. Additionally, we also tested the hypothesis that PE promotes cognitive recovery in 11–13 month old reproductive senescent female rats. In contrast to males, the same intensity of exercise that decrease cognitive deficits in males was not able to promote cognitive recovery in female rats. Additionally, we determined that exercise did not lessen infarct volume in both male and female rats. There are many factors that contribute to higher stroke mortality and morbidities in women and thus, future studies will investigate the effects of PE in aged female rats to identify sex differences. [ABSTRACT FROM AUTHOR]

Key points: Maternal exercise improves the metabolic health of maternal mice challenged with a high‐fat diet.Exercise intervention of obese mothers prevents fetal overgrowth.Exercise intervention reverses impaired placental vascularization in obese mice.Maternal exercise activates placental AMP‐activated protein kinase, which was inhibited as a result of maternal obesity. More than one‐third of pregnant women in the USA are obese and maternal obesity (MO) negatively affects fetal development, which predisposes offspring to metabolic diseases. The placenta mediates nutrient delivery to fetuses and its function is impaired as a result of MO. Exercise ameliorates metabolic dysfunction resulting from obesity, although its effect on placental function of obese mothers has not been explored. In the present study, C57BL/6J female mice were randomly assigned into two groups fed either a control or a high‐fat diet (HFD) and then the mice on each diet were further divided into two subgroups with/without exercise. In HFD‐induced obese mice, daily treadmill exercise during pregnancy reduced body weight gain, lowered serum glucose and lipid concentration, and improved insulin sensitivity of maternal mice. Importantly, maternal exercise prevented fetal overgrowth (macrosomia) induced by MO. To further examine the preventive effects of exercise on fetal overgrowth, placental vascularization and nutrient transporters were analysed. Vascular density and the expression of vasculogenic factors were reduced as a result of MO but were recovered by maternal exercise. On the other hand, the contents of nutrient transporters were not substantially altered by MO or exercise, suggesting that the protective effects of exercise in MO‐induced fetal overgrowth were primarily a result of the alteration of placental vascularization and improved maternal metabolism. Furthermore, exercise enhanced downstream insulin signalling and activated AMP‐activated protein kinase in HFD placenta. In sum, maternal exercise prevented fetal overgrowth induced by MO, which was associated with improved maternal metabolism and placental vascularization in obese mothers with exercise. Key points: Maternal exercise improves the metabolic health of maternal mice challenged with a high‐fat diet.Exercise intervention of obese mothers prevents fetal overgrowth.Exercise intervention reverses impaired placental vascularization in obese mice.Maternal exercise activates placental AMP‐activated protein kinase, which was inhibited as a result of maternal obesity. [ABSTRACT FROM AUTHOR]

Background. The present study examined the relationship between insulin resistance and both waist circumference and cardiorespiratory fitness in U.S. adolescents. Methods. NHANES assessed a nationally representative sample of U.S. adolescents (12-18 yrs) between 1999-2002. Abdominal adiposity was estimated by waist circumference, overall adiposity by BMI, and cardiorespiratory fitness (maximal oxygen uptake (VO2max) from a treadmill exercise test). Insulin resistance was estimated from fasting insulin and glucose using the homeostatic model assessment method (i.e., HOMA) and was log-transformed. Results. 1078 adolescents were included in the study. Positive correlations existed between lnHOMA and waist circumference (r = 0.59; r = 0.54) for boys and girls, respectively. lnHOMA and VO2max were inversely related in boys (r = -0.29) but not girls (r = -0.06.) Gender-specific analyses by BMI category showed that the significant inverse relationship in lnHOMA and VO2max was primarily present in obese boys. Conclusion. Among adolescents, important gender and BMI differences exist in the relationship between insulin resistance and fitness.While waist circumference and BMI are important predictors in all children, fitness appears especially important in obese boys. These findingsmay have important implications for gender-specific interventions to prevent adult obesity and diabetes mellitus. [ABSTRACT FROM AUTHOR]

Background and Purpose Infants with Down syndrome (DS) are consistently late walkers. The purpose of this investigation was to test the effects of individualized, progressively more intense treadmill training on developmental outcomes in infants with DS. Subjects Thirty infants born with DS were randomly assigned to receive lower-intensity, generalized treadmill training or higher-intensity, individualized training implemented by their parents in their homes. Methods Research staff members monitored implementation of training, physical growth, and onset of motor milestones of all infants on a monthly basis. Results Infants in the higher-intensity, individualized training group increased their stepping more dramatically over the course of training. Infants in the higher-intensity training group attained most of the motor milestones at an earlier mean age. Discussion and Conclusion Treadmill training of infants with DS is an excellent supplement to regularly scheduled physical therapy intervention for the purpose of reducing the delay in the onset of walking. [ABSTRACT FROM AUTHOR]

This study evaluated the effects of exergaming on college students' energy expenditure (EE), moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), rating of perceived exertion (RPE), and enjoyment compared to traditional treadmill exercise, and sex differences. Sixty college students (30 female; X ¯ age = 23.6 ± 4.1 years) completed three 20-min exercise sessions on Xbox 360 Kinect Just Dance (Microsoft, Redmond, WA, USA), Xbox 360 Kinect Reflex Ridge (Microsoft, Redmond, WA, USA), and treadmill walking. Their EE and PA were assessed by ActiGraph accelerometers (ActiGraph Co.; Pensacola, FL, USA); RPE every four min; enjoyment via an established scale. Significant exercise-type by sex interaction effects were observed for RPE (p < 0.01): females reported significantly lower RPE during exergaming sessions but significantly higher RPE during treadmill walking. Results revealed significant main effects for all outcomes between exercise sessions (all p < 0.01): treadmill walking resulted in significantly higher metabolic equivalents (METs), MVPA, and EE (p < 0.01), yet lower LPA (p < 0.01), compared to the two exergaming sessions. Participants' RPE was significantly higher during treadmill walking than during exergaming sessions, with exergaming eliciting significantly higher enjoyment (all p < 0.01). College students find exergaming more enjoyable and report lower RPE compared to traditional treadmill exercise, though not yet matching the moderate physiological intensity level. [ABSTRACT FROM AUTHOR]

Question: Do treadmill training and resistance training improve the functional performance of patients with peripheral arterial disease (PAD)? Design: Randomised, controlled trial with blinded outcome assessment and stratification for symptoms of intermittent claudication (IC). Setting: Tertiary hospital in the USA. Participants: Participants with an ankle brachial index of 0.95 or less were recruited from vascular clinics and the community. Key exclusion criteria were critical limb ischaemia, foot ulcers, amputation, inability to attend or perform the interventions, and usual exercise comparable to the study regimens. Randomisation of 156 participants allotted 51 to treadmill training, 52 to resistance training and 53 to a control group. Interventions: The treadmill group performed supervised treadmill exercise 3 times per week for 6 months. Participants aimed to increase to 40 minutes by week 8, after which the speed or grade of the treadmill was progressed. Participants with IC were encouraged to exercise to near maximal leg symptoms. Asymptomatic participants exercised at a perceived exertion of 12 to 14 on the Borg scale. The resistance group also performed supervised exercise 3 times per week for 6 months, including 3 sets of 8 repetitions of resisted lower limb exercises. External resistance was maintained above 50% of 1 repetition maximum and perceived exertion at 12 to 14. The control group attended 11 sessions that were designed to provide contact with a health professional but not to change behaviour. Outcome measures: The primary outcomes were the change in the six-minute walk test (6MWT) and the short physical performance battery (SPPB) at 6 months. The SPPB assesses walking speed, balance, and sit-to-stand performance. Secondary outcome measures were treadmill endurance, lower limb strength, endothelial function measured non-invasively at the brachial artery, habitual physical activity measured over 7 days via an accelerometer, a walking impairment questionnaire (WIQ), and the SF-36 quality of life questionnaire. Results: Compared to control, treadmill training significantly improved 6MW distance (by 36 m, 95% CI 15 to 57), total treadmill time (by 3.4 min, 95% CI 2 to 4.8), pain-free treadmill time (by 1.6 min, 95% CI 0.3 to 2.9), endothelial function, and the Distance domain of the WIQ. Compared to control, resistance training significantly improved total treadmill time (by 1.9 min, 95% CI 0.5 to 3.3), knee extension strength (by 80 N, 95% CI 37 to 124), and the Distance and Stair Climbing domains of the WIQ. Both regimens produced significant, 7.5-point improvements in the Physical Functioning domain of the SF-36. Conclusion: Treadmill and resistance training have different benefits for people with peripheral arterial disease, but both improve quality of life. [ABSTRACT FROM AUTHOR]