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First morning urine (FMU) assessment would be a practical and convenient solution for clinically acceptable detection of underhydration prior to competition/training, and for the general public. Thus, we thus sought to determine the diagnostic accuracy of FMU as a valid indicator of recent (previous 24 hr, 5 days average) hydration practices. For 5 consecutive days and one final morning, 67 healthy women (n = 38) and men (n = 29; age: 20 [1] years, body mass index: 25.9 [5.5]) completed 24-hr diet logs for total water intake (from beverages and foods, absolute and relative to body mass), 24-hr urine and FMU collection (last morning only) for osmolality (Osm), specific gravity (SG), and color (Col), and morning blood sampling for plasma osmolality and copeptin. Correlations determined significance and relationship strength among FMU and all other variables. Area under the receiver operating characteristic curves, sensitivity, specificity, and positive likelihood ratios were employed using previously reported values to indicate underhydration (total water intake < 30 ml/kg, osmolality > 500, and >800 mOsm/kg, specific gravity > 1.017, and copeptin > 6.93 pmol/L). FMU_Osm and FMU_SG were significantly correlated (p <.05) to all variables except the previous 5-day plasma osmolality. FMU_Col was only significantly correlated with other color time intervals and total water intake per gram. FMU_Osm held greatest utility (area under the receiver operating characteristic curve, sensitivity, and specificity >80%) overall, with the best outcome being FMU_Osm indicating a previous 24-hr osmolality threshold of 500 mOsm/kg (FMU_Osm criterion >710 mOsm/kg and positive likelihood ratio = 5.9). With less effort and cost restriction, FMU is a viable metric to assess underhydration. [ABSTRACT FROM AUTHOR]

Few previous review articles have focused on the associations between inadequate daily water intake (LOW) or urinary biomarkers of dehydration (UD; low urine volume or high urine osmolality) and multiple diseases. Accordingly, we conducted manual online searches (47 key words) of the PubMed, Embase, and Google Scholar databases with these inclusion criteria: English language, full-text, peer reviewed, no restriction on research design, and three publications minimum. Initially, 3,903 articles were identified based on their titles and abstracts. Evaluations of full length.pdf versions identified 96 studies that were acceptable for inclusion. We concluded that the evidence is insufficient or conflicting for seven disorders or diseases (i.e. suggesting the need for additional clarifying research) and it is lacking for all-cause mortality. Differential characterizations among women and men have been reported in the results of nine studies involving five diseases. Finally, the evidence for associations of LOW or UD is strong for both kidney stones and type 2 diabetes with hyperglycemia. This suggests that great public health value (i.e. reduced disease risk) may result from increased daily water intake—a simple and cost-effective dietary modification. [ABSTRACT FROM AUTHOR]

Introduction: Continuous recognition tasks (CRTs) assess episodic memory (EM), the central functional disturbance in Alzheimer's disease and several related disorders. The online MemTrax computerized CRT provides a platform for screening and assessment that is engaging and can be repeated frequently. MemTrax presents complex visual stimuli, which require complex involvement of the lateral and medial temporal lobes and can be completed in less than 2 min. Results include number of correct recognitions (HITs), recognition failures (MISSes = 1-HITs), correct rejections (CRs), false alarms (FAs = 1-CRs), total correct (TC = HITs + CRs), and response times (RTs) for each HIT and FA. Prior analyses of MemTrax CRT data show no effects of sex but an effect of age on performance. The number of HITs corresponds to faster RT-HITs more closely than TC, and CRs do not relate to RT-HITs. RT-HITs show a typical skewed distribution, and cumulative RT-HITs fit a negative survival curve (RevEx). Thus, this study aimed to define precisely the effects of sex and age on HITS, CRs, RT-HITs, and the dynamics of RTs in an engaged population. Methods: MemTrax CRT online data on 18,255 individuals was analyzed for sex, age, and distributions of HITs, CRs, MISSes, FAs, TC, and relationships to both RT-HITs and RT-FAs. Results: HITs corresponded more closely to RT-HITs than did TC because CRs did not relate to RT-HITs. RT-FAs had a broader distribution than RT-HITs and were faster than RT-HITs in about half of the sample, slower in the other half. Performance metrics for men and women were the same. HITs declined with age as RT-HITs increased. CRs also decreased with age and RT-FAs increased, but with no correlation. The group over aged 50 years had RT-HITs distributions slower than under 50 years. For both age ranges, the RevEx model explained more than 99% of the variance in RT-HITs. Discussion: The dichotomy of HITs and CRs suggests opposing cognitive strategies: (1) less certainty about recognitions, in association with slower RTHITs and lower HIT percentages suggests recognition difficulty, leading to more MISSes, and (2) decreased CRs (more FAs) but faster RTs to HITs and FAs, suggesting overly quick decisions leading to errors. MemTrax CRT performance provides an indication of EM (HITs and RT-HITs may relate to function of the temporal lobe), executive function (FAs may relate to function of the frontal lobe), processing speed (RTs), cognitive ability, and age-related changes. This CRT provides potential clinical screening utility for early Alzheimer's disease and other conditions affecting EM, other cognitive functions, and more accurate impairment assessment to track changes over time. [ABSTRACT FROM AUTHOR]

PURPOSES: To establish a normative range of MemTrax (MTx) metrics in the Chinese population. METHODS: The correct response percentage (MTx‐%C) and mean response time (MTx‐RT) were obtained and the composite scores (MTx‐Cp) calculated. Generalized additive models for location, shape and scale (GAMLSS) were applied to create percentile curves and evaluate goodness of fit, and the speed‐accuracy trade‐off was investigated. RESULTS: 26,633 subjects, including 13,771 (51.71%) men participated in this study. Age‐ and education‐specific percentiles of the metrics were generated. Q tests and worm plots indicated adequate fit for models of MTx‐RT and MTx‐Cp. Models of MTx‐%C for the low and intermediate education fit acceptably, but not well enough for a high level of education. A significant speed‐accuracy trade‐off was observed for MTx‐%C from 72 to 94. CONCLUSIONS: GAMLSS is a reliable method to generate smoothed age‐ and education‐specific percentile curves of MTx metrics, which may be adopted for mass screening and follow‐ups addressing Alzheimer's disease or other cognitive diseases. Highlights: GAMLSS was applied to establish nonlinear percentile curves of cognitive decline.Subjects with a high level of education demonstrate a later onset and slower decline of cognition.Speed‐accuracy trade‐off effects were observed in a subgroup with moderate accuracy.MemTrax can be used as a mass‐screen instrument for active cognition health management advice. [ABSTRACT FROM AUTHOR]

Background: Whereas the Montreal Cognitive Assessment (MoCA) and Addenbrooke's cognitive examination-revised (ACE-R) are commonly used tests for the detection of post-stroke cognitive impairment (PSCI), these instruments take 10-30 min to administer and do not assess processing speed, which is a critical impairment in PSCI. MemTrax (MTx) is a continuous recognition test, which evaluates complex information processing, accuracy, speed, and attention, in 2 min. Aim: To evaluate whether MTx is an effective and practical tool for PSCI assessment. Methods: This study enrolled acute ischemic stroke (AIS) patients who have assessed the cognitive status including MTx, clinical dementia rating (CDR), MoCA, Neuropsychiatric Inventory (NPI), Hamilton depression scale (HAMD), Hamilton anxiety scale (HAMA), the National Institute of Health Stroke Scale (NIHSS), modified Rankin scale (mRS), and Barthel Index of activity of daily living (BI) combined with the physical examinations of the neurologic system at the 90-day (D90) after the AIS. The primary endpoint of this study was establishing MTx cut-offs for distinguishing PSCI from AIS. Results: Of the 104 participants, 60 were classified to the PSCI group. The optimized cut-off value of MTx-%C (percent correct) was 78%, with a sensitivity and specificity for detecting PSCI from Non-PSCI of 90.0 and 84.1%, respectively, and an AUC of 0.919. Regarding the MTx-Cp (Composite score = MTx-%C/MTx-RT), using 46.3 as a cut-off value, the sensitivity and specificity for detecting PSCI from Non-PSCI were 80.0 and 93.2%, with an AUC of 0.925. Multivariate linear regression showed that PSCI reduced the MTx-%C (Coef. -14.18, 95% CI -18.41~-9.95, p < 0.001) and prolonged the MTx-RT (response time) (Coef. 0.29, 95% CI 0.16~0.43, p < 0.001) and reduced the MTx-CP (Coef. -19.11, 95% CI -24.29~-13.93, p < 0.001). Conclusion: MemTrax (MTx) is valid and effective for screening for PSCI among target patients and is a potentially valuable and practical tool in the clinical followup, monitoring, and case management of PSCI. [ABSTRACT FROM AUTHOR]

Although July and August tend to be the warmest months of the year, the months leading up to summer as well as the months just following summer can also be quite warm or even very hot. In this article, the authors share some important information to help prepare physical educators for overseeing activities in the heat and, just as importantly, to prepare their students, the parents, and school administrators. A child's ability to regulate core body temperature in the heat is influenced by a number of factors, including the environment, intensity and duration of physical activity, hydration status, cardio-respiratory fitness, body composition, health status, current use of medications, and clothing, uniforms, or protective equipment. Keep in mind that students can still overheat while exercising in the heat, even if they are well hydrated and fit.

The health benefits of engaging in regular physical activity are widely known: enhanced cardiorespiratory fitness, increased muscular strength and endurance, and favorable cholesterol and other profiles. Nevertheless, particularly in youth sports programs run by volunteer, and perhaps inadequately trained, coaches, many youth may not realize the health benefits of sports participation due to a number of factors, among them, inappropriate coach-child ratios, limited space, or mismatched expectations between coaches and those of children and their parents. There are specific strategies that can be implemented to ensure that youth receive the maximize benefits from participation in sports. These strategies are presented in the following areas: frequency, intensity, and duration; cross-training or complementary exercise; access points; utilization of space and time; nutrition; and rest. For instance, with regard to the frequency of physical activity, some sports, including soccer, basketball, and singles tennis, require extensive physical effort over an extended period of time, while others, such as baseball and football, have a lot of downtime. Thus, in order for children and youth to meet the recommendation of participating in moderate or vigorous physical activity at least four times per week, sports programs need to have opportunities for all athletes to practice hard. Finally, the author discusses the point at which participation in sports might be too much, leading to significant injuries, frustration, and resentment. (Contains 29 notes.)