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Changes in glucose and insulin are potentially involved in the appetite-regulatory effects of exercise considering their role post-prandially., Purpose: To examine if glucose and insulin play a role in post-exercise appetite regulation., Methods: 12 participants (M=8; 26±5 y) completed 3 experimental sessions in a systematically rotated randomized crossover design: 1) no-exercise control (CTRL); 2) moderate-intensity continuous training (MICT; 30-min, 70% maximal oxygen consumption (V̇O2max)); and 3) sprint interval training (SIT; 4 x 30-s "all-out" sprints, interspersed with 4-min rest). Plasma glucose, insulin, acylated ghrelin, active peptide tyrosine tyrosine (PYY), active glucagon-like peptide-1 (GLP-1), and overall appetite perceptions were measured pre-exercise, 0-, 30-, 60-, and 120-min post-exercise. Energy intake was recorded the day before, of, and after experimental sessions., Results: Glucose was elevated 0-min post-exercise (p<0.097, d>0.52) compared to CTRL with no differences between exercise bouts. Acylated ghrelin was suppressed by MICT (60-, 120-min) and SIT (0-, 30-, 60-, 120-min; p<0.080, d> 0.56) compared to CTRL, while also suppressed in SIT compared to MICT at 30-, 60-, 120-min (p<0.026, d>0.74). GLP-1 was elevated following MICT (0-, 30-, 60-min) and SIT (60-min; p<0.094, d>0.53) compared to CTRL and following MICT compared to SIT (0-min; p=0.005, d=1.03). Overall appetite was suppressed by SIT post-exercise (p<0.058, d>0.61) compared to CTRL and MICT, and by MICT 0-min post-exercise compared to CTRL (p=0.036, d=0.71). There were no exercise effects on insulin, PYY, or free-living energy intake (p>0.217, ηp2<0.130)., Conclusion: Glucose and insulin do not appear to play a role in exercise-induced appetite suppression.

The addition of low-dose protein to low protein-containing meals in middle-to-older aged adults may promote greater postprandial plasma aminoacidemia and mitigate declines in muscle health but may be dependent on the source and quality of protein consumed. This single-blind randomised study investigated postprandial plasma aminoacidemia and appetite regulatory responses to a typical lower protein-containing (∼0.07 g·kg body mass[BM] -1 ) mixed breakfast supplemented with ∼0.13 g·kg BM - 1 of whey protein concentrate (MB + WPC) or pea protein isolate (MB + PPI) in middle-to-older aged adults. Venous blood samples were collected whilst fasted and over a 180-min postprandial period to determine plasma amino acid and appetite hormone concentrations. Perceived appetite ratings were measured using Visual Analogue Scales. Plasma total amino acids and essential amino acids increased over time (both P < 0.05) with no between-group differences or overall availability over 180 min (incremental area under the curve (iAUC)). Plasma leucine concentrations increased over time (both P < 0.05) with greater peak concentrations (P = 0.032) and iAUC (P = 0.012) in MB + WPC compared with MB + PPI. Plasma total-ghrelin and total-GLP-1 concentrations and perceived ratings of hunger, fullness, and satiety were transiently altered following MB + WPC and MB + PPI (P < 0.05 for all), with no differences between groups. In middle-to-older aged adults, co-ingesting a small bolus of whey protein alongside a typical lower protein-containing breakfast elicits greater plasma leucinemia than co-ingestion of pea protein, with no differential impact on appetite regulation. Whether the addition of low-dose whey protein to typical meals of middle-to-older aged adults can enhance muscle anabolism without adversely affecting appetite remains to be determined., (© 2025. The Author(s).)

For children with cerebral palsy (CP), walking on uneven surfaces (US) is a challenging task essential for their engagement in their daily lives. This study aims to compare spatiotemporal parameters of multiple domains of walking (pace, rhythm, stability, variability) in children with spastic CP between gait on an uneven surface (US) and an even surface (ES) and assess differences against their typically developing (TD) peers. A total of 34 children (17CP/17TD) walked at a self-selected speed on an US and an ES. Gait speed, stride length, stride time, walk ratio, cadence, double and single support time, and stride width were calculated. For each parameter, stride-to-stride variability was calculated using the coefficient of variation. A 2-way ANOVA (group, surface) was conducted on each parameter. Stride width, and variability of gait speed, cadence, and walk ratio presented a group × surface interaction (p ≤ 0.042). Post-hoc tests revealed a greater stride width, and variability of gait speed, and walk ratio in the CP, compared to the TD group (p ≤ 0.005) only on an US, and on both surfaces for cadence variability (p = 0.017). Gait analysis on an US reveals gait changes in children with CP, highlighting the importance of using more ecological approaches for gait assessment., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Purpose: To test the effects of a physical activity intervention program on symptoms of mental disorders among adolescents., Methods: This study is a 12-week cluster randomized controlled trial. The sample consisted of 306 adolescents (45,8% male, age: 13,6 [0,72] years; 54.2% female, age: 13.5 [0.69] years), randomized into an intervention group (N = 165) and a control group (N = 141). The physical activity program involved sessions including muscle strengthening and cardiorespiratory exercises and lifestyle guidance. The mental health indicators analyzed were: anxiety, depression, sleep, and psychological well-being. Intervention effects were analyzed by generalized estimating equations., Results: After 12 weeks, no significant improvements were observed in the intervention group for sleep; anxiety; depression, and psychological well-being. In the subgroup analysis, significant group×time interactions were observed for adolescents who were classified with moderate symptoms of depression (mean difference: -0.97, p = 0.002) and anxiety (mean difference: -3.03, p = 0.01) with favorable effects for intervention group., Conclusion: After the 12-week intervention period, it can be concluded that 12 weeks of school-based physical activity intervention significantly reduced symptoms of anxiety and depression in adolescents with moderate/severe symptoms. Furthermore, the intervention contributed to the maintenance of psychological well-being, since the control group showed a significant reduction in this mental health indicator., Competing Interests: Declarations. Ethics approval and consent to participate: The studies involving human participants were reviewed and approved by the Human Research Ethics Committee of the State University of Northern of Parana, Brazil (no: 4.452.513). All procedures applied in the research study were in accordance with the Declaration of Helsinki. Informed consent was obtained from all participants and their literate legal guardian. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

The influence of appetite and energy intake on energy compensation in response to chronic exercise remains poorly understood. This study examined the temporal impact of habitual exercise on energy intake and the homeostatic appetite regulators that influence energy compensation. Twelve-week-old male Sprague Dawley rats (n=30) fed an AIN-93M diet were randomised into 1 of 3 groups: 1) sedentary control (SED); 2) voluntary wheel exercise (EX); and 3) sedentary, weight-matched to aerobic exercise (SED-WM) for 8 weeks. Measures of energy intake, body weight, and adiposity were assessed. Appetite-regulating hormones acyl-ghrelin, active GLP-1, leptin, and insulin were measured in response to an oral glucose tolerance test. Rats with running wheels completed an average of 192kms over 8 weeks. While energy intake was initially reduced in EX, energy intake gradually increased with exercise training after week 1 (P<0.05). Body weight was lower in EX relative to SED from weeks 3-5, but did not differ at the end of the study. Fat mass and long-term satiety hormones leptin and insulin were lower in EX (P<0.05). No differences were observed in concentrations of the satiety hormone active GLP-1 or the orexigenic hormone acyl-ghrelin. Short-term homeostatic regulators of appetite do not appear to be altered with exercise training. The reduction in adiposity and associated decrease in tonic satiety hormones leptin and insulin are likely contributors to the coupling of energy expenditure with energy intake over time with voluntary exercise.

The Oxford Foot Model (OFM) is a widely-used multi-segment foot model for the evaluation of foot motion. To date, custom code based on the original scientific publications have failed to reproduce results available through the Vicon plug-in (ViconOFM). This highlights a lack of transparency, affecting the accessibility and understanding of the model. Therefore, the aims of this study are to (1) replicate ViconOFM using Python for open-source distribution (openOFM v1.0) and (2) reproduce the original scientific description of the OFM in a second version (openOFM v1.1), highlighting differences between both versions. A dataset comprising one healthy adult and a set of five patients with heterogeneous foot pathologies was used for analyses. Evaluation was conducted using the normalised root mean square error (NRMSE) between the inter-segment angles and arch heights of both implementations. The openOFM v1.1 was developed based on the original OFM publications. The average NRMSE between ViconOFM and openOFM v1.0, using both healthy and pathological gait, was of 0.0012. Based on our openOFM v1.1 implementation, differences between ViconOFM and the original OFM description from the literature are due to an integrated smoothing and gap filling function and changes in segment definitions. The negligible differences between ViconOFM and openOFM v1.0 in healthy and pathological gait supports the concurrent validity of openOFM. Providing users with both openOFM versions enables informed use of either model and allows further investigation into the implications of these differences. The open-source nature of the project promotes further development.

It has been proposed that the sensorimotor system provides a foundation for the development of cognitive abilities and their hemispheric specialization. In this study, we investigated the potential relationship between haptic processing and mental rotation ability, both of which are typically lateralized to the right hemisphere. Previous research has also indicated that males tend to outperform females in both functions. The current study investigates how the sensorimotor-haptic system relates to mental rotation ability, specifically to examine the influence of hand performance (as a proxy for hemispheric specialization) and biological sex on this relationship. Seventy-five participants (n = 41 females) completed a haptic task, and the well-known mental rotation test (MRT) developed by Shepard and Metzler (Science 171:701-3, 1971). Results confirmed a positive correlation between performance on the haptic and MRT tasks. Further, males outperformed females in both tasks. However, when sex and hand performance were considered, males were better in the haptic task, but only when using their left-hand. Moreover, left-hand haptic performance was the sole predictor of MRT performance. These findings suggest that sex differences in haptic processing may contribute to the observed sex differences in mental rotation ability, supporting the view that sensorimotor processes shape cognitive function and its hemispheric lateralization., Competing Interests: Declarations. Ethics approval and consent to participate: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent: Informed consent was obtained from all individual participants included in the study. Consent for publication: Informed consent was obtained from all individualparticipants included in the study. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background: Although it is generally accepted that aerobic exercise training does not change lung structure or function, some work suggests that greater pulmonary vascular structure and function are associated with higher exercise capacity (peak rate of oxygen consumption [V˙o 2 peak])., Research Question: Is there a cross-sectional association between the pulmonary vasculature and V˙o 2 peak? We hypothesized that those with higher CT blood vessel volumes and pulmonary diffusing capacity for carbon monoxide (Dlco) would have higher V˙o 2 peak, independent of airflow limitation., Study Design and Methods: Participants from the Canadian Cohort Obstructive Lung Disease (CanCOLD) study were categorized as follows: participants with normal spirometry who had never smoked (n = 263), participants with normal spirometry who had ever smoked (n = 407), and COPD: individuals with spirometric airflow obstruction (n = 334). Total vessel volume (TVV), volume for vessels < 5 mm 2 in cross-sectional area (BV5), and volume for vessels between 5 and 10 mm 2 in cross-sectional area (BV5-10) were generated from CT scans and used as indices of pulmonary vascular structure. Dlco was used as an index of pulmonary microvascular function. V˙o 2 peak was evaluated via incremental cardiopulmonary exercise testing., Results: General linear regression models revealed that even after controlling for FEV 1 , emphysema severity, and body morphology, Dlco, TVV, BV5, and BV5-10, were independently associated with V˙o 2 peak. Interaction effects were observed between COPD and TVV, BV5, and BV5-10, indicating a weaker association between pulmonary vascular volumes and V˙o 2 peak in COPD., Interpretation: Our results suggest that pulmonary vascular structure and Dlco are independently associated with V˙o 2 peak, regardless of severity of airflow limitation and emphysema, suggesting that these associations are not limited to COPD., Competing Interests: Financial/Nonfinancial Disclosures The authors have reported to CHEST the following: M. K. reports consulting fees related to the content of the manuscript from VIDA Diagnostics Inc (Coralville, IA). W. T. reports support from the Canadian Institute of Heath Research (CIHR/Rx&D Collaborative Research Program Operating Grants 93326) with industry partners Astra Zeneca Canada Ltd, Boehringer-Ingelheim Canada Ltd, GlaxoSmithKline Canada Ltd, Merck, Novartis Pharma Canada Inc, Nycomed Canada Inc, and Pfizer Canada Ltd for conducting the longitudinal population-based Canadian Cohort of Obstructive Lung Disease (CanCOLD) study on COPD. J. B. reports grants or contracts from CIHR, Réseau en santé respiratoire du FRQS, McGill University, McGill University Health Centre Foundation, AstraZeneca Canada Ltd, Boehringer Ingelheim Canada Ltd, GlaxoSmithKline Canada Ltd, Grifols, Novartis, Sanofi, and Trudell Canada Ltd, paid to his institution; and payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from AstraZeneca Canada Ltd, Boehringer Ingelheim Canada Ltd, GlaxoSmithKline Canada Ltd, Trudell Canada Ltd, Pfizer Canada Ltd, and COVIS Pharma Canada Ltd. S. S. reports grants from the ATS as chair for ATS/ERS Updated Technical Standard on PFT interpretation; reports consulting fees from Chiesi Pharmaceuticals; reports speaker fees from Vyaire Medical; holds a leadership position at the American Thoracic Society and European Respiratory Society; is on a medical advisory board at Ndd Technologies; and is statistical editor at Thorax, an editorial board member at the European Respiratory Journal, and associate editor at Canadian Journal of Respiratory, Critical Care and Sleep Medicine, outside the submitted work. None declared (S. É. C., B. M. S., S. T., S. D., D. J. M. K. S.)., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Background: Public safety personnel (PSP) experience occupational stressors and potentially psychologically traumatic events, which increase the odds of screening positive for mental health disorders, and the risk of suicide. This study estimates suicidal ideation, planning, and attempts among Canadian PSP, and assesses associations with Emotional Resilience Skills Training (ERST)., Method: The current study uses a longitudinal prospective sequential experimental cohort design that engages participants for approximately 16 months. Participants (n = 186, 60.5% men) were administered the structured Mini-International Neuropsychiatric Interview at three time points relative to the ERST: pre-training, post-training, and 1-year follow-up., Results: At pre-training, PSP reported past-month suicidal ideation (n = 24; 12.9%), planning (n = 7; 3.8%), and no attempts. At post-training, PSP reported past-month suicidal ideation (n = 12; 10.1%), suicidal planning (n < 5), and no attempts (n = 0). At the 1-year follow-up, PSP reported past-month suicidal ideation (n = 7; 12.5%), and no planning (n = 0) or attempts (n = 0)., Conclusions: The results indicate suicide-related challenges for PSP, particularly PSP who self-identify as women and females. The results suggest sector-specific differences in suicide attempts, indicating unique sector-specific challenges among PSP. The results evidenced reductions in suicidal ideation and planning directly after ERST; however, attrition impacted analyses at 1-year follow-up. Additional sector-specific mixed-methods research would help inform suicide mitigation strategies., Trial Registration: ClinicalTrials.gov, NCT05530642. Hypotheses Registration: aspredicted.org, #90136. Registered 7 March 2022-Prospectively registered., (© 2025 American Association of Suicidology.)

Background: Fusion changes the biomechanics of the spine leading to the potential development of adjacent segment disease. Despite many studies on adjacent segment disease, it is largely unknown how spinal fixation affects the mechanical properties of the adjacent disc. The purpose of this study was to assess whether axial compression causes mechanical disruption to the annulus when the caudal spinal level is immobilized or injured., Methods: Fifty-two porcine spines were assigned to one of four conditions: 1) control; 2) injured (18.5-gauge needle inserted into the nucleus of cervical 4/5); 3) immobilized (18-gauge steel wire wrapped around the transverse and spinous processes of cervical 4/5); and 4) injured+immobilized. Each specimen was then subjected to 0.5 Hz cyclic compression (300-1200N) for two hours. Post-compression, three annular samples were dissected from the cervical 3/4 disc (adjacent to immobilized and/or injured level) and mechanically tested. The same loading protocol and annular testing was also conducted in eight human cadaveric lumbar spines., Findings: Immobilization and injury resulted in a reduction in adjacent disc lamellar strength including toe region stress (p < 0.001), initial failure stress (p = 0.03), and ultimate stress (p = 0.004), with immobilization having the greatest impact. Similar findings were observed in the human cadaver samples with reduced toe region strength in the injured+ immobilized samples compared to the control (p = 0.049)., Interpretation: The current study provides empirical evidence of decreased lamellar strength in the disc adjacent to an immobilized and/or injured level following prolonged cyclic axial loading, lending mechanistic insight into the development of adjacent segment disease., Competing Interests: Declaration of competing interest None declared., (Copyright © 2025 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Purpose: This study assessed the individual and combined effects of sports bras and breast volume on pulmonary system and respiratory symptom responses to exercise in recreationally active females., Methods: Twenty-three healthy females (18-27 yr; bra sizes 32B-36DDD) were divided into small and large breast volume groups (SBV and LBV, respectively) around median volume (324 mL; mean ± SD SBV: 284 ± 38 mL vs LBV: 560 ± 97 mL; P < 0.001, g = 3.84). Participants completed three 5-min bouts of constant-load cycle exercise at 30%, 60%, and 90% of their peak power output while wearing a high-support sports bra, low-support sports bralette, or their personal (self-selected) sports bra in randomized order. Measurements included ventilation, breathing pattern, respiratory pressures, diaphragm electromyogram (EMGdi), and ratings of perceived exertion (RPE), breathlessness (intensity and unpleasantness), and chest tightness due to bra., Results: Compared with low-support and personal sports bras, the high-support sports bra evoked stronger sensations of restricted breathing and chest tightness ("slight" to "moderate" restriction in n = 7 (30%) vs n = 1 (4%) in low-support and personal bras; P = 0.014). There was, however, no evidence of greater concomitant inspiratory constraints, EMGdi, or inspiratory muscle pressure generation in either bra (all P > 0.05). Notably, LBV compared with SBV, participants reported greater RPE ( P = 0.037, ηp2 = 0.20), breathlessness intensity ( P = 0.039, ηp2 = 0.20), and unpleasantness ( P = 0.041; ηp2 = 0.19), which, in the setting of comparable pulmonary system responses to exercise, was likely driven by stronger perceived chest tightness and/or bra awareness in LBV participants., Conclusions: Despite evoking mild-to-moderately severe chest tightness due to bra during exercise, correctly fitted sports bras, whether low- or high-support, do not impose a physiological burden to the respiratory system and its response to mild-to-heavy intensity exercise in otherwise healthy females., (Copyright © 2024 by the American College of Sports Medicine.)

Background: Vertebral fractures in young populations are associated with intervertebral disc disorders later in life. However, damage to the annulus fibrosus has been observed in rapidly loaded spines even without the subsequent occurrence of a fracture. Therefore, it may not be the fracture event that compromises the disc, but rather the manner in which the disc is loaded. The purpose of this study was to quantify the mechanical properties of the annulus fibrosus following quasi-static compressive loading of the motion segment either to sub-fracture or fracture-inducing magnitude., Methods: Porcine cervical motion segments were axial compressed at 0.1 mm/s, either until endplate fracture occurred ('fracture group'), or until segments reached 75 % of average fracture stress as determined from the fracture group ('sub-fracture group'). An unloaded control group was also included. Post-loading, three samples of the annulus were excised. The first was mounted in a 180 o peel test configuration in order to quantify lamellar adhesion. The other two samples were excised from the superficial and midspan region of the annulus and were exposed to uniaxial tension to 50 % strain., Findings: Lamellar adhesion and tensile annulus mechanics did not differ between the fracture and sub-fracture group, nor between the unloaded controls., Interpretation: Given the lack of differences in annular mechanical properties across the three conditions, it was concluded that under very slow, quasi-static compressive loading conditions, the annulus appeared undamaged even in the group that sustained a fracture; this is likely because a significant viscoelastic response was not generated in the disc under these slow loading conditions., Competing Interests: Declaration of competing interest The authors have no conflicts of interest to declare. Funding for this study was provided by the Natural Sciences and Engineering Research Council of Canada (RGPIN-2020-04723)., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Although previous work has demonstrated that oral contraceptive pill (OCP) use does not affect resting muscle sympathetic nerve activity (MSNA), growing evidence indicates that it attenuates neurogenic vasoconstriction. Despite these advances, it remains unknown how OCP use affects the ability of MSNA to dynamically control vascular tone and arterial blood pressure (BP) on a beat-by-beat basis. Thus, we tested the hypothesis that, compared with naturally menstruating females (MC), those using OCPs will exhibit attenuated sympathetic vascular transduction at rest. Forty-three females [MC: n = 21, 26 (4) yrs; OCP: n = 22, 24 (4) yrs; data are presented as means (SD)] completed 10 min of supine rest with continuous measurements of beat-by-beat BP, femoral artery blood flow (26 females; MC: n = 13, OCP: n = 13), and MSNA. Spike-triggered averaging was used to determine sympathetic transduction into leg vascular conductance (LVC) and BP for 12 cardiac cycles following MSNA bursts. Overall sympathetic-BP transduction ( P = 0.293), as well as sympathetic-BP transduction of MSNA burst quartiles ( P = 0.741) and burst firing patterns ( P = 0.452) were not different between the MC and OCP groups. Conversely, sympathetic vascular transduction per unit MSNA burst amplitude ( P = 0.026) and burst firing pattern ( P = 0.014) were attenuated among females using OCPs. In addition, females using OCPs demonstrated progressively smaller leg vasoconstrictor responses as a function of MSNA burst firing pattern compared with MC females ( P = 0.021). Collectively, these data indicate that, in premenopausal females, OCP use attenuates the leg vasoconstrictor responses to bursts of MSNA, particularly during periods of increased sympathetic neural drive, without affecting the transduction of MSNA bursts into beat-by-beat changes in BP. NEW & NOTEWORTHY This study investigated the impact of OCP use on the transduction of MSNA bursts into regional vasoconstriction and blood pressure in premenopausal females. We demonstrated that females using OCPs exhibit attenuated sympathetic transduction into LVC; however, this does not translate to reductions in sympathetic blood pressure transduction. Collectively, these data indicate that OCP use may alter the local vasoconstrictor response to bursts of MSNA; however, compensatory mechanisms may contribute to maintain sympathetic blood pressure transduction.

Polycystic ovary syndrome (PCOS) predisposes women to cardiovascular diseases. Blood pressure (BP) responses to the cold pressor test (CPT) predict future cardiovascular risk but have yet to be characterized in PCOS. Therefore, we compared BP responses to the CPT between females with PCOS [ n = 10; age: 22 ± 3 yr, body mass index (BMI): 23.9 ± 3 kg/m 2 ] and healthy controls (CTRL; n = 10; age: 22 ± 2 yr, BMI: 22.1 ± 2 kg/m 2 ). BP (finger photoplethysmography calibrated to manual sphygmomanometry-derived values), femoral blood flow (duplex ultrasound), and vascular resistance [FVR; mean arterial pressure (MAP)/blood flow] were measured continuously at baseline and across a 3-min hand CPT. Venous blood samples were used to quantify the free androgen index (FAI; total testosterone/sex hormone binding globulin × 100). Baseline MAP was not different between PCOS and CTRL (87 ± 7 vs. 82 ± 11 mmHg, respectively; P = 0.25), nor was systolic BP (SBP; 109 ± 9 vs. 106 ± 7 mmHg; P = 0.42). Across the CPT, MAP and SBP were higher in PCOS than CTRL (main effects of group, both P < 0.05). Peak CPT induced increases in MAP (+12 ± 5 vs. +7 ± 4 mmHg; P = 0.04) and corresponding changes in SBP (+13 ± 7 vs. +7 ± 3 mmHg; P = 0.04) and FVR (+0.17 ± 0.08 vs. +0.02 ± 0.13 mmHg/mL/min; P = 0.01) were larger in PCOS than CTRL. Within-group regressions indicated that FAI was positively associated with relative increases in peak MAP ( R 2 < 0.01) and corresponding changes in FVR ( P < 0.01) and corresponding changes in FVR ( R 2 = 0.83, P < 0.01) in females with PCOS but not in CTRL (MAP: R 2 = 0.41). Young, lean females with PCOS demonstrate exaggerated BP and vascular responses to the CPT that may be indicative of elevated cardiovascular risk mediated in part by the detrimental effects of elevated androgens. P Young, lean, and otherwise healthy females with polycystic ovary syndrome (PCOS) demonstrated exaggerated blood pressure responses to the cold pressor test (CPT) relative to controls. CPT responses were associated with bioavailable androgens, suggesting that hyperandrogenism contributes to exaggerated responses to the CPT in PCOS. Given associations between CPT responsiveness and the subsequent development of hypertension, these findings add to mounting evidence for increased cardiovascular risk even in lean females with PCOS.R 2 = 0.12, P = 0.41). Young, lean females with PCOS demonstrate exaggerated BP and vascular responses to the CPT that may be indicative of elevated cardiovascular risk mediated in part by the detrimental effects of elevated androgens. NEW & NOTEWORTHY Young, lean, and otherwise healthy females with polycystic ovary syndrome (PCOS) demonstrated exaggerated blood pressure responses to the cold pressor test (CPT) relative to controls. CPT responses were associated with bioavailable androgens, suggesting that hyperandrogenism contributes to exaggerated responses to the CPT in PCOS. Given associations between CPT responsiveness and the subsequent development of hypertension, these findings add to mounting evidence for increased cardiovascular risk even in lean females with PCOS.

Objective: This study compared the effect of cardiovascular high-intensity interval training (HIIT) vs moderate-intensity continuous training (MICT) on psychosocial responses to exercise, motivation, and enjoyment, in individuals with chronic stroke., Design: A secondary analysis of motivation and enjoyment outcomes collected from a randomized controlled trial (NCT03614585) comparing 12 weeks of HIIT vs MICT in participants with chronic stroke (6-60mo post-stroke) was conducted., Setting: General community., Participants: Seventy-one individuals (N=71) with chronic stroke (mean ± SD, age: 65.5 ± 8.4y, 19.4 ± 13.4mo post-stroke, 38% women) and mild disability (median ± interquartile range, National Institutes of Health Stroke Scale score 1 ± 2)., Interventions: Twelve-week, 3 per week progressive cardiovascular HIIT or MICT program conducted on NuStep recumbent steppers., Main Outcome Measures: Motivation (Behavioral Regulation in Exercise Questionnaire-3) was measured at weeks 1, 6, and 12. Enjoyment outcomes comprised of affective response (Feeling Scale) assessed at each training session, and post-exercise enjoyment (Physical Activity Enjoyment Scale) assessed at weeks 6 and 12. Linear mixed models, examining group, time and group × time point interactions in motivation constructs and composite scores, mean affective response per session, and post-exercise enjoyment were used to compare the effect of HIIT vs MICT., Results: HIIT elicited a lower affective response (mean difference [95% CI]: -1.18 [-1.90 to -0.47]; P=.002), that also progressively declined during sessions, in contrast to MICT (group × time point interaction: F [2,63.5]=3.99, P=.02). HIIT and MICT did not elicit any significant difference between groups or change over time for post-exercise enjoyment or any motivation constructs (P>.05)., Conclusions: Despite lower affective response during exercise, HIIT elicits equivalent motivation and post-exercise enjoyment compared to MICT. This study provides further support for the implementation of HIIT in stroke rehabilitation by demonstrating sustained responses of motivation and post-enjoyment. Future studies should consider potential strategies that positively reinforce these important psychosocial responses to implement HIIT in post-stroke rehabilitation., (Copyright © 2025 The Authors. Published by Elsevier Inc. All rights reserved.)

Busy walking paths, like in a park, city centre, or shopping mall, frequently necessitate collision avoidance behaviour. Lab-based research has shown how different situation- and person-specific factors, typically studied independently, affect avoidance behaviour. What happens in the real world is unclear. Thus, we filmed unscripted pedestrian walking behaviours on a busy urban path. We leveraged deep learning algorithms to identify and extract pedestrian walking trajectories and had unbiased raters characterize situations where two pedestrians approached each other from opposite ends. We found that smaller medial-lateral distance between approaching pedestrians and smaller crowd size predicted an increased likelihood of a subsequent path deviation. Furthermore, we found that whether a pedestrian looked distracted or held, pushed, or pulled an object predicted medial-lateral distance between pedestrians at time of crossing. Our results highlight both similarities and differences with lab-based behaviour and offer insights relevant to developing accurate computational models for realistic pedestrian movement., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Community-based physical activity programmes benefit persons with disabilities. However, there is a lack of evidence-based tools to support kinesiologists' training in such programmes. This study aimed to co-create and evaluate physical activity training modules for community-based adapted physical activity (APA) programmes. In Phase 1, a working group (n = 8) consisting of staff, kinesiologists from two community-based APA programmes, and researchers met over four online meetings to discuss needs, co-create training modules, and assess usability. In Phase 2, a pre-post quasi-experimental design evaluated changes in capability, opportunity, and motivation of kinesiologists (n = 14) after completing the training modules, which included standardized mock client assessments and participant ratings of module feasibility. Means and standard deviations were computed for feasibility, followed by paired-samples t-tests, along with Hedge's correction effect size. Mock client sessions underwent coding and reliability assessment. The working group meetings generated two main themes: training in (i) motivational interviewing and behaviour change techniques and (ii) optimizing APA prescription. Nine online training modules were created. In Phase 2, medium to large effects of training modules were observed in capability (Hedge's g = 0.67-1.19) for 8/9 modules, opportunity (Hedge's g = 0.77-1.38) for 9/9 modules, and motivation (Hedge's g = 0.58-1.03) for 6/9 modules. In mock client assessments, over 78% of participants appropriately used five behaviour change techniques and, on average, participants demonstrated good use of motivational interviewing strategies. The findings indicate that training kinesiologists was feasible and has the potential to enhance community-based physical activity programmes for persons with disabilities., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Society of Behavioral Medicine.)

Golfers must modify their motor patterns when the demands of a putting task change. The objective was to compare joint angles and putter kinematics during putting at two distances and inclines. Recreational golfers ( n = 14) completed putts over four conditions: 3-foot putts on flat and incline surfaces, and 7-foot putts on flat and incline surfaces. A Vicon motion capture system measured kinematic data. Joint angles, putter angles, and spatiotemporal variables were calculated. Analysis of variance compared spatiotemporal variables, and statistical parametric mapping compared angles between putts. There were faster putter head and ball velocities during longer and incline putts. The amplitude and time of backswing increased with longer putts. Longer putts resulted in increased trunk axial rotation during backswing, downswing, and follow-through, while incline putts only resulted in greater rotation during follow-through. There were minimal differences in shoulder angle. There was greater head rotation toward the hole during all putting phases for longer putts and during follow-through for incline putts. The trunk is the primary mechanism to increase putter head amplitude, and thereby velocity, when putting from longer distances. A similar strategy could be used when putting uphill. Additional work should confirm these results in highly skilled golfers.

Background: Bullying has been identified as a risk factor for many issues among adolescents. Although it was already considered a public health issue in Brazil before the COVID-19 pandemic, little is known about how the pandemic and associated public health measures have affected bullying behavior., Objective: To explore changes in bullying victimization and perpetration among Brazilian high school students from 2019 to 2022., Methods: This study utilizes data from the Longitudinal Study of Adolescent Lifestyle (ELEVA), employing a repeated cross-sectional with a nested cohort design. Adolescents (n = 1.987, 50.2% female, mean age 16.4 years) answered a questionnaire and bullying-related information were extracted from two different questions for victims and perpetrators. Multilevel logistic regression models were used., Results: Bullying victimization decreased from 46% (95% CI: 40-52%) in 2019 to 30% (95% CI: 24-36%) in 2022 (OR: 0.46, 95% CI: 0.30-0.69, p < 0.05) in the longitudinal sample. Stable prevalences of bullying victimization (44% in 2019, 40% in 2022, p = 0.090) and perpetration (9.7% in 2019. 8.7% in 2022, p = 0.5) were observed within the repeated cross-sectional sample., Conclusion: This study found a significant decrease in bullying victimization among Brazilian high school students from 2019 to 2022 in the longitudinal sample, which coincides with the decrease in bullying behavior associated with getting older. However, the prevalence of bullying victimization and perpetration remained relatively stable and high in the repeated cross-sectional sample. These findings highlight the need for effective policies and interventions to prevent bullying among high school students. Additionally, providing resources and support for students experiencing bullying could be beneficial., Competing Interests: Declarations. Ethics approval and consent to participate: The study was conducted in accordance with the Declaration of Helsinki, its later amendments, or comparable ethical standards, and was approved by the Research Ethics Board of the Federal University of Santa Catarina (protocol numbers: 3.168.745 and 5.652.499). Informed assent and consent were obtained from all participants, with parental consent provided for those who were underaged (under 18 years old at the date of recruitment). Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background: Self-directed interventions are cost-effective for patients with cancer and their family caregivers, but barriers to use can compromise adherence and efficacy., Aim: Pilot a Sequential Multiple Assignment Randomized Trial (SMART) to develop a time-varying dyadic self-management intervention that follows a stepped-care approach in providing different types of guidance to optimize the delivery of Coping-Together, a dyadic self-directed self-management intervention., Methods: 48 patients with cancer and their caregivers were randomized in Stage 1 to: (a) Coping-Together (included a workbook and 6 booklets) or (b) Coping-Together + lay telephone guidance. At 6 weeks, change in distress level was assessed, and non-responding dyads were re-randomized in Stage 2 to (a) continue with their Stage 1 intervention or (b) be stepped-up. Benchmarks for acceptability, feasibility, and clinical significance (anxiety and quality of life (QOL)) were assessed via surveys and study logs., Results: Feasibility was supported by a low refusal rate at ≤ 30% and < 10% missing data. Men and women were enrolled in at least a 40:60 ratio for caregivers, but less for patients. Recruitment was slow at 1 dyad/week. Acceptability was supported by a low attrition rate (12.5%) and with 87% of participants finding the booklets helpful. Telephone guidance in Stage 1 increased adherence to Coping-Together; however, in Stage 1, participants benefited more from the self-directed format than the guidance. All patients who were stepped-up in Stage 2 benefited from their new assignment; this trend was less clear for caregivers., Significance: Findings suggest a 3-step approach to dyadic self-management support that warrants further testing., Trial Registration: Clinical Trials Registration #: NCT04255030., (© 2025 The Author(s). Psycho‐Oncology published by John Wiley & Sons Ltd.)

High-load resistance exercise (>60% of 1-repetition maximum) is a well-known stimulus to enhance skeletal muscle hypertrophy with chronic training. However, studies have intriguingly shown that low-load resistance exercise training (RET) (≤60% of 1-repetition maximum) can lead to similar increases in skeletal muscle hypertrophy as compared to high-load RET. This has raised questions about the underlying mechanisms for eliciting the hypertrophic response with low-load RET. A key characteristic of low-load RET is performing resistance exercise to, or close to, task failure, thereby inducing muscle fatigue. The primary aim of this evidence-based narrative review is to explore whether muscle fatigue may act as an indirect or direct mechanism contributing to skeletal muscle hypertrophy during low-load RET. It has been proposed that muscle fatigue could indirectly stimulate muscle hypertrophy through increased muscle fibre recruitment, mechanical tension, ultrastructural muscle damage, the secretion of anabolic hormones, and/or alterations in the expression of specific proteins involved in muscle mass regulation (e.g., myostatin). Alternatively, it has been proposed that fatigue could directly stimulate muscle hypertrophy through the accumulation of metabolic by-products (e.g., lactate), and/or inflammation and oxidative stress. This review summarizes the existing literature eluding to the role of muscle fatigue as a stimulus for low-load RET-induced muscle hypertrophy and provides suggested avenues for future research to elucidate how muscle fatigue could mediate skeletal muscle hypertrophy.

Foot strike patterns influence vertical loading rates during running. Running retraining interventions often include switching to a new foot strike pattern. Sudden changes in the foot strike pattern may be uncomfortable and may lead to higher step-to-step variability. This study evaluated the effects of running with an imposed and usual foot strike on vertical loading rate variability and amplitude. Twenty-seven participants (16 men and 11 women; age range: 18-30 years) ran on an instrumented treadmill with their usual foot strike for 10 min. Then, the participants were instructed to run with an unusual foot strike for 6 min. We calculated the vertical instantaneous and vertical average loading rates and their variances over 200 steps to quantify vertical loading rate variability. We also calculated the amplitude and variability of the shank acceleration peak using an inertial measurement unit. The vertical loading rate and shank acceleration peak amplitudes were higher when running with a rearfoot strike, regardless of the foot strike conditions (i.e., usual or imposed). The vertical loading rate and shank acceleration peak variability were higher when running with an imposed rearfoot strike than when running with a usual forefoot strike. No differences were found in the vertical loading rate and shank acceleration peak variabilities between the imposed forefoot strike and usual rearfoot strike conditions. This study offers compelling evidence that adopting an imposed (i.e., unusual) rearfoot strike amplifies loading rate and shank acceleration peak variabilities.

Background: Exertional breathlessness is a key symptom in cardiorespiratory disease and can be quantified using incremental exercise testing, but its prognostic significance is unknown. We evaluated the ability of abnormally high breathlessness intensity during incremental cycle exercise testing to predict all-cause, respiratory, and cardiac mortality., Study Design and Methods: Longitudinal cohort study of adults referred for exercise testing followed prospectively for mortality assessed using the Swedish National Causes of Death Registry. Abnormally high exertional breathlessness was defined as a breathlessness intensity response (Borg 0-10 scale) > the upper limit of normal using published reference equations. Mortality was analyzed using multivariable Cox regression, unadjusted and adjusted for age, sex, and body mass index. A further mortality analysis was also done adjusted for select common comorbidities in addition to age, sex and body mass index., Results: Of the 13,506 people included (46% female, age 59±15 years), 2,867 (21%) had abnormally high breathlessness during exercise testing. Over a median follow up of 8.0 years, 1,687 (12%) people died. No participant was lost to follow-up. Compared to those within normal predicted ranges, people with abnormally high exertional breathlessness had higher mortality from all causes (adjusted hazard ratio [aHR] 2.3, [95% confidence interval] 2.1-2.6), respiratory causes (aHR 5.2 [3.4-8.0]) and cardiac causes (aHR 3.0 [2.5-3.6]). Even among people with normal exercise capacity (defined as peak Watt ≥75% of predicted exercise capacity, n = 10,284) those with abnormally high exertional breathlessness were at greater risk of all-cause mortality than people with exertional breathlessness within the normal predicted range (aHR 1.5 [1.2-1.8])., Conclusion: Among people referred for exercise testing, abnormally high exertional breathlessness, quantified using healthy reference values, independently predicted all-cause, respiratory and cardiac mortality., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Elmberg et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Competing Interests: Author DW was employed by Simulation Curriculum Corp during part of the study. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Branched-chain amino acids (BCAA: leucine, isoleucine and valine) are three of the nine indispensable amino acids, and are frequently consumed as a dietary supplement by athletes and recreationally active individuals alike. The popularity of BCAA supplements is largely predicated on the notion that they can stimulate rates of muscle protein synthesis (MPS) and suppress rates of muscle protein breakdown (MPB), the combination of which promotes a net anabolic response in skeletal muscle. To date, several studies have shown that BCAA (particularly leucine) increase the phosphorylation status of key proteins within the mechanistic target of rapamycin (mTOR) signalling pathway involved in the regulation of translation initiation in human muscle. Early research in humans demonstrated that BCAA provision reduced indices of whole-body protein breakdown and MPB; however, there was no stimulatory effect of BCAA on MPS. In contrast, recent work has demonstrated that BCAA intake can stimulate postprandial MPS rates at rest and can further increase MPS rates during recovery after a bout of resistance exercise. The purpose of this evidence-based narrative review is to critically appraise the available research pertaining to studies examining the effects of BCAA on MPS, MPB and associated molecular signalling responses in humans. Overall, BCAA can activate molecular pathways that regulate translation initiation, reduce indices of whole-body and MPB, and transiently stimulate MPS rates. However, the stimulatory effect of BCAA on MPS rates is less than the response observed following ingestion of a complete protein source providing the full complement of indispensable amino acids.

There is currently no efficient way to quantify overhead throwing volume in water polo. Therefore, this study aimed to test the feasibility of a method to detect passes and shots in water polo automatically using inertial measurement units (IMU) and machine-learning algorithms. Eight water polo players wore one IMU sensor on the wrist (dominant hand) and one on the sacrum during six practices each. Sessions were filmed with a video camera and manually tagged for individual shots or passes. Data were synchronised between video tagging and IMU sensors using a cross-correlation approach. Support vector machine (SVM) and artificial neural networks (ANN) were compared based on sensitivity and specificity for identifying shots and passes. A total of 7294 actions were identified during the training sessions, including 945 shots and 5361 passes. Using SVM, passes and shots together were identified with 94.4% (95%CI = 91.8-96.4) sensitivity and 93.6% (95%CI = 91.4-95.4) specificity. Using ANN yielded similar sensitivity (93.0% [95%CI = 90.1-95.1]) and specificity (93.4% [95%CI = 91.1 = 95.2]). The results suggest that this method of identifying overhead throwing motions with IMU has potential for future field applications. A set-up with one single sensor at the wrist can suffice to measure these activities in water polo.

Lactate has been implicated in exercise-induced appetite suppression though little work has explored the mechanisms underpinning its role. Recent work suggests lactate accumulation via exercise and intracerebroventricular injection can alter central appetite regulating pathways, though a supraphysiological dose of lactate was administered centrally and there was no assessment of peripheral appetite markers. Therefore, we examined how physiologically relevant lactate accumulation via exercise or intraperitoneal injection altered central and peripheral appetite signaling pathways and whether the lactate dehydrogenase inhibitor oxamate could blunt any exercise effect. Forty 10-week-old C57BL/6 J male mice (n = 10/group) were assigned to either: 1) sedentary (SED + SAL; saline); 2) exercise (EX+SAL; saline); 3) exercise with oxamate (EX+OX; 750 mg‧kg -1 body mass); or 4) lactate (SED + LAC; 1.0 g‧kg -1 body mass). Blood, stomach, and hypothalamus samples were collected ∼2 h post-exercise/injection. Though oxamate blunted exercise-induced lactate accumulation compared to the EX+SAL condition (P = 0.044, d = 0.73), there were no differences in circulating acylated ghrelin or stomach ghrelin O-acyltransferase content between groups (P > 0.213, η p <0.125). There were also no differences in hypothalamic content for neuropeptide Y, proopiomelanocortin, agouti-related peptide, and alpha melanocyte-stimulating hormone (P > 0.150, η 2 <0.170). Exercise did increase phosphorylated-total signal transducer and activator of transcription 3 (pSTAT3) compared to EX+OX (p = 0.065, d = 1.23) but there were no differences in other markers of lactate signaling: phosphorylated-total adenosine monophosphate activated protein kinase, and protein kinase b (P > 0.121, η p 2 <0.170). Exercise did increase phosphorylated-total signal transducer and activator of transcription 3 (pSTAT3) compared to EX+OX (p = 0.065, d = 1.23) but there were no differences in other markers of lactate signaling: phosphorylated-total adenosine monophosphate activated protein kinase, and protein kinase b (P > 0.121, η p 2 <0.160). Our results suggest that lactate accumulation due to exercise or peripheral injection does not alter central or peripheral appetite signaling when measured 2 h post-exercise/injection, though pSTAT3 was blunted with oxamate., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

This study compared the kinematics of upper body and cue stick among players of various skill levels when performing back spin and top spin shots. Twenty-eight male cue sports players were assigned to the novice (n = 10), intermediate (n = 9), or skilled groups (n = 9). The back spin and top spin tests were administrated while kinematic data were recorded using a 3D motion capture system. The results revealed greater upper limb joint ranges of motions (all p  < 0.05), maximum angular velocities (all p  < 0.05), and cue tip speed in the back spin than top spin shots ( p  < 0.001). None of joint kinematic or shot performance variables investigated was significantly different among the three skill levels (all p  > 0.05). For the head movement, the novice group exhibited greater anteroposterior displacement than the skilled group ( p  = 0.020). In conclusion, except for the head movement, the upper body and cue stick kinematics did not significantly differ among players with varied skill levels. Greater joint ranges of motions and angular velocities were required to generate a faster cue tip speed for the back spin shots when compared with the top spin shots.

Study Design: Guided by the 4-step process outlined in the Consensus-based Standards for the selection of health Measurement INstruments (COSMIN) guideline, multiple methodologies were used: Delphi, literature reviews, ratings with consensus, think-aloud, and test-retest., Objectives: The purpose of this study was to develop and test a spinal cord injury (SCI) peer support evaluation tool that meets the needs of community-based SCI organizations in Canada., Setting: Peer support programs for people with SCI delivered by community-based SCI organizations., Methods: This research was co-constructed with executives and staff from SCI community-based organizations, people with SCI, researchers, and students. Given the multiple steps of this study, sample size and characteristics varied based on each step. Participants included people with SCI who received peer support (mentees) or provided peer support (mentors/supporters) and staff of community-based organizations., Results: In step 1, the 20 most important outcomes for SCI peer support were identified. In step 2 and 3, the 97 items were identified to assess the outcomes and by using rating and multiple consensus methodologies 20 items, one to assess each outcome, were selected. In step 4, content and face validity and test-retest reliability were achieved. The resulting SCI Peer Support Evaluation Tool consists of 20 single-item questions to assess 20 outcomes of SCI peer support., Conclusion: Through a systematic process, the SCI Peer Support Evaluation Tool is now ready to be implemented to assess outcomes of SCI peer support programs delivered by community-based SCI organizations., Competing Interests: Competing interests: The authors declare no competing interests. Ethical approval: We certify that all applicable institutional and governmental regulations concerning the ethical use of human volunteers were followed during the course of this research. Ethics approval for this study was obtained from the McGill University Research Ethics Board (REB#: 21-11-011)., (© 2024. The Author(s).)

Purpose of Review: Breathlessness is a common, distressing and limiting symptom in people with advanced disease, but is challenging to assess as the symptom intensity depends on the level of exertion (symptom stimulus) during the assessment. This review outlines how to use recently developed normative reference equations to evaluate breathlessness responses, accounting for level of exertion, for valid assessment in symptom research., Recent Findings: Published normative reference equations are freely available to predict the breathlessness intensity response (on a 0-10 Borg scale) among healthy people after a 6-minute walking test (6MWT) or an incremental cycle cardiopulmonary exercise test (iCPET). The predicted normal values account for individual characteristics (including age, sex, height, and body mass) and level of exertion (walk distance for 6MWT; power output, oxygen uptake, or minute ventilation at any point during the iCPET). The equations can be used to (1) construct a matched healthy control dataset for a study; (2) determine how abnormal an individual's exertional breathlessness is compared with healthy controls; (3) identify abnormal exertional breathlessness (rating > upper limit of normal); and (4) validly compare exertional breathlessness levels across individuals and groups., Summary: Methods for standardized and valid assessment of exertional breathlessness have emerged for improved symptoms research., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Background/aim: Exertional breathlessness is a dominating symptom in cardiorespiratory disease, limiting exercise capacity. Multidimensional measurement has been proposed to capture breathlessness, but it is unknown whether it is useful to differentiate people with abnormal vs normal exertional breathlessness intensity., Methods: This was a secondary analysis of a randomized controlled trial of outpatients aged ≥ 18 years performing a symptom-limited cycle incremental exercise test (IET). Breathlessness sensations at end of IET were identified using the multidimensional dyspnea profile (MDP) 30-min post-exercise and compared between people with abnormally high breathlessness (Borg 0-10 rating > upper limit of normal [ULN]) and people within normal ranges (≤ ULN) in relation to the percentage of predicted peak power output defined by normative reference equations., Results: Of 92 participants, 20 (22 %) had abnormally high breathlessness. Compared with those with normal breathlessness (n = 72 [78 %]), the abnormal group reported higher symptom intensity at peak exercise (7.9 ± 1.7 vs 6.3 ± 1.4 Borg units; p < 0.001) and had lower peak power output 129 ± 52 W vs 167 ± 55 W; p < 0.001). Differences between those with normal, and abnormal exertional breathlessness regarding MDP ratings were not statistically significant (all p > 0.05): overall unpleasantness, 4.1 ± 2.3 vs 4.7 ± 1.6; immediate perception, 10.9 ± 2.8 vs 11.5 ± 1.8; and emotional response, 4.1 ± 7.6 vs 3.2 ± 7.5. MDP ratings had no relation to peak power output., Conclusion: Breathlessness dimensions are similar at the peak of a standardized IET and cannot differentiate between people with normal and abnormally high exertional breathlessness., (Copyright © 2025 The Authors. Published by Elsevier B.V. All rights reserved.)

Context: Energy intake may differ across the menstrual cycle, with some studies identifying greater energy intake in the luteal phase (LP) compared with the follicular phase (FP) and others finding no clear differences. To date, no study has systematically synthesized the available data to draw more definite conclusions while considering any methodological inconsistencies between studies., Objective: The aim was to conduct a systematic review/meta-analysis in an effort to determine if there are differences in energy intake between the FP and LP., Data Sources: A systematic search strategy was developed and the search was conducted in 5 databases for studies that investigated any changes in energy intake across menstrual phases., Data Extraction: Using Covidence, studies were identified and included if they contained individuals between the ages of 18 and 45 years, maintained an average body mass index (BMI) of 18.5-25 kg/m2, had no history of disordered eating, and included energy intake and menstrual cycle measurements in the FP and LP., Data Analysis: Effect sizes were calculated for each study and a random-effects model was used to pool the results of each study., Results: Fifteen datasets were included consisting of 330 female participants with a mean age of 26 ± 4 years and mean BMI of 22.4 ± 2.3 kg/m2. Overall, there was a statistically significant difference (standardized mean difference = 0.69; P = .039) with increased energy intake in the LP compared with the FP (crude 168 kcal⋅d-1 average difference between phases)., Conclusion: Energy intake was found to be greater in the LP compared with the FP, providing insight into the effect of the menstrual cycle on energy intake. However, there were repeated methodological inconsistencies and future work should strive to utilize best practices for both energy intake measurement and menstrual phase specification., (© The Author(s) 2024. Published by Oxford University Press on behalf of the International Life Sciences Institute.)

Objectives: To compare injunctive norm scores assessed based on Ajzen's (2002) original normative referent elicitation method (e.g., norms from those who approve/disapprove of physical activity) and a revised method (e.g., norms from those who are personally influential)., Methods: Undergraduate students (N T1  = 1008, N T2 = 383) were initially randomly assigned to either the condition that used Ajzen's original method or the condition that used the revised method, and completed an online survey. A month later, participants completed the survey in the reverse condition. Data collection occurred October 2021-July 2022. Data were analyzed to examine the differences between the two conditions regarding the mean injunctive norm scores and their indirect effects on physical activity via intentions (i.e., moderated mediation)., Results: Mixed ANOVA results indicated a statistically significant effect of condition (p < .001): the injunctive norm score assessed based on the revised method was lower compared to the original method. After accounting for baseline physical activity, a statistically significant moderated mediation was found with intention strength as the mediator (95% bootstrap CIs [.02, .20]): there was a statistically significant indirect effect of injunctive norms on physical activity via intention strength under the revised condition, but this effect was statistically nonsignificant under the original condition. There was no statistically significant moderated mediation with decisional intention as the mediator (95% bootstrap CIs [-.04, .13])., Conclusions: Null findings regarding the relationship between injunctive norms and physical activity intentions typically found in the literature may be partially explained by the way in which norms were measured., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Esophageal adenocarcinoma continues to bear high morbidity and mortality. Prehabilitation, using exercise, nutrition, and psychosocial strategies to optimize patients prior to surgical resection, is largely underexplored in this malignancy, especially in patients undergoing neoadjuvant chemotherapy. Objectives of this study were (i) to determine feasibility of prehabilitation during treatment in patients with esophageal cancer and (ii) to establish differences between hospital and home-based exercise. Patients were recruited from August 2019 - February 2023 and blindly randomized to either supervised or homebased exercise, receiving identical nutritional and psychosocial support. The main outcome measures were recruitment, retention, and dropout rates. The secondary outcomes included cardiorespiratory fitness, functional capacity, and quality of life. Forty-four subjects were blindly randomized: 23 to supervised exercise and 21 to home-based exercise (72% recruitment rate). Overall compliance for the supervised group was 72%; home-based group was 77%. Baseline to pre-operative, both groups experienced significant increases in sit-to-stand, arm curls, and amount of weekly moderate-vigorous physical activity. The home-based group experienced an additional considerable decrease in up-and-go test times. Both groups maintained cardiorespiratory fitness and saw substantial increases in some quality-of-life scores. Multimodal prehabilitation is feasible for patients with esophageal cancer undergoing neoadjuvant chemotherapy. In both groups, patient fitness, which is relevant for this patient population given the anticipated decline in functional status during this period, was maintained. This study provides a foundation for future prehabilitation interventions in this patient population., (© The Author(s) 2024. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus.)

Background: Many adults do not meet physical activity recommendations for optimal health, and this is often because people find it difficult to maintain physical activity in the long term. This study focuses on identifying and synthesising factors that may influence the maintenance of physical activity in adults with and without known health conditions., Method: A systematic review and qualitative synthesis using thematic analysis was conducted. Four databases (MEDLINE, SPORT Discus, APA, and Web of Science) were systematically searched for studies published from inception to February 2023 that included qualitative data about people's experiences of maintaining physical activity., Results: A total of 9337 abstracts were screened and 68 studies from 14 countries were included. Six main themes were identified: (1) influence of others (e.g. four forms of social support, accountability); (2) contextual and environmental influences (e.g. cost and access of physical activity, weather); (3) health-related influences (e.g. reflexivity about how physical activity improves health conditions, weight control); (4) making it work (e.g. flexibility, prioritising exercise); (5) habits; and (6) psychological processes (e.g. enjoyment, identifying as a physically active person)., Conclusion: People who maintained their participation in physical activity found it enjoyable, prioritised it, and integrated it into their daily routine. Participants were motivated to continue being physically active when they realised the benefits for their health. Social support, in particular companion support, was a key component facilitating continued engagement. Findings specific to maintenance of physical activity included reflexivity of how physical activity benefited health, flexibility, and identifying as a physically active person., Competing Interests: Declarations Ethics Approval Not applicable. Informed Consent Not applicable Conflict of Interest The authors declare no competing interests. Disclaimer The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, or the Department of Health and Social Care., (© 2024. The Author(s).)

Background: Medical school involves high expectations of medical students, which may increase their risk for burnout. Physical activity (PA) and sedentary behaviour (SB) are modifiable risk factors for burnout. However, medical students are insufficiently taught about PA and SB and may therefore be less likely to meet guideline-recommended levels of these two movement behaviours or promote them in practice. Few studies have examined the relationships between medical students' PA intensity, SB, and burnout; such examination could help clarify educational needs for improving levels of movement behaviours and their promotion., Purpose: This study investigated (1) the relationships between light, moderate, vigorous, and total PA, SB, and burnout among medical students, and (2) moderate-to-vigorous PA as a moderator of the relationship between SB and burnout, to guide future curriculum renewal., Methods: Medical students ( N = 129) at two Canadian institutions completed online validated questionnaires assessing light, moderate, vigorous, and total PA, SB, and burnout., Results: Regression analyses indicated that light PA ( β = -.191, p = .039) and SB ( β =-.230, p = .013) were negatively associated with burnout. Moderate-to-vigorous PA did not significantly moderate the relationship between SB and burnout., Conclusions: Engaging in lighter forms of PA and SB within guideline recommendations may help mitigate medical student burnout. Competencies to promote movement behaviours may dually target medical student burnout and curriculum gaps., Competing Interests: The opinions and conclusions expressed are the writers’ own and are not those of the Canadian Medical Association., (© 2024 Morgan, McFadden, Fortier, Sweet, Tomasone; licensee Synergies Partners.)