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Depression and mood disturbances among college women are prevalent concerns, prompting the investigation of interventions to improve mental well-being. This study explores the efficacy of a structured resistance training program tailored for women in enhancing self-efficacy and reducing mood disturbances over a 4-week period. Participants were recruited voluntarily and underwent a 4-week Women on Weights program, consisting of twice-weekly sessions. Pre- and post-surveys, including Beck's Depression Inventory (BDI), Self-Efficacy for Exercise (SEE), and Abbreviated Profile of Mood States (POMS), were administered to assess changes in mental health outcomes. Statistical analyses were conducted using paired t-tests and unpaired t-tests. Results indicate a significant reduction in depression symptoms across all participants, as measured by the BDI. While the SEE Scale did not show significant changes, the POMS survey revealed significant improvements in the Esteem-Related Affect subscale, suggesting an enhancement in self-efficacy post-intervention. Additionally, a trending significance was observed in the POMS Depression subscale, indicating a potential impact on depression symptoms with a larger sample size. These findings highlight the potential of resistance training interventions to improve mental well-being among college women.

Objective: To evaluate water consumption and body water content of recreational athletes to determine their effects on physical fitness and performance. Methods: This secondary cross-sectional investigation utilized data from Drexel University. Participants had their data collected over two visits to the laboratory. Measurements taken in the original study included: aerobic fitness assessed via maximal oxygen consumption (VO2max) using a metabolic cart, resting metabolic rate (RMR) evaluated using a metabolic cart, body composition measured by dual-energy X-ray absorptiometry (DXA), body water content measured by bioelectrical impedance analysis (BIA), kilocalories (kcals) from vigorous physical activity measured using Actical accelerometers, water consumption assessed by asking participants how much water they consumed the day prior to each visit (at both time points), and dietary data from the 2005 Block Food Frequency Questionnaire (FFQ). R studio (RStudio 2023.12.1 Build 402 "Ocean Storm" for Windows, 2024, Posit Software, PBC, Boston, MA) was utilized to run linear models that fit all covariates (age, sex, body weight, height, body mass index [BMI], kcals from vigorous activity), water consumption obtained at time points 1 and 2, extracellular water [ECW], intracellular water [ICW], total body water [TWC] obtained by BIA at time point 1 only). These models analyzed the two-way interaction of VO2max to the water variables or covariates. These models also analyzed three-way interactions of VO2max to water variables and covariates combined. A stepwise linear regression was then used, and analysis of variance (ANOVA) tests were performed. Linear regression of the significant water variables was plotted showing variations in age and sex. Results: A total of 141 individuals (65 females and 76 males), 18 to 64 years of age, were included in the secondary cross-sectional analyses. The youngest age group had the highest mean VO2max and body water content (47.8 mL/kg/mi

Food allergies pose a significant health risk, affecting millions of Americans, with symptoms ranging from mild discomfort to life-threatening anaphylaxis. Likewise, autoimmune diseases, where the immune system attacks healthy tissues, encompass a wide range of conditions, each with distinct symptoms and impacts on various organs. Through an analysis of Single Nucleotide Polymorphisms (SNPs), this research explores associations between specific genetic markers and phenotypic outcomes related to allergies and autoimmune diseases. Utilizing data from the genetic testing service 23andMe, this study investigated how genetic makeup may be related to individual responses to food, shedding light on underlying molecular mechanisms. Results demonstrate significant associations between certain SNPs and disease outcomes, highlighting the potential for personalized interventions in managing allergies and autoimmune disorders. This research contributes to a deeper understanding of personalized nutrition and may pave the way for novel approaches to disease prevention and management.

Throughout the pandemic, Virginia Tech Recreational Sports operations were adapted in compliance with federal, state, and local guideline to ensure the safety of the students it serves as a department. Operational adjustments that were made included closures, limited capacities, and virtual programming to name a few. Participation rates in all areas of Virginia Tech Recreational Sports naturally saw a significant decrease during the pandemic due to these restrictions. This project investigated the impact of the COVID-19 pandemic on student engagement in campus recreation, or recreational sports, programs at Virginia Tech with a focus on facility gym swipes, group exercise attendance, and intramural sports involvement spanning three distinct time periods: pre-COVID (T1), during COVID (T2), and post-COVID (T3). Virginia Tech Recreational Sports data uploaded to Virginia Tech’s University Data Commons was used to analyze engagement numbers for students at the undergraduate and graduate level across various demographics including academic college, race/ethnicity, and gender. Statistical tests for significance were not able to be completed with the data in this study alone, so the results were only interpreted qualitatively. This study indicates that there has been a gradual return to pre-COVID engagement and participation levels in all areas of Virginia Tech Recreational Sports, but the return has been varied across each area. Intramurals appears to have higher involvement post-COVID than pre-COVID, whereas gym swipes and group exercise participation numbers have not returned to pre-COVID levels for most demographics. Return to pre-COVID participation levels varies between academic colleges, race/ethnicity, and gender for all areas. Research plays an integral role in informing decisions and developing strategies that will shape the future of campus recreation. Understanding how student engagement has evolved as a result of the pandemic can guide programmers within Virgi

During nine years of active-duty service in the United States Army as an Officer, it has always been abundantly clear that there are discernable differences between male and female soldiers, which is amplified when you compare their physical abilities and performances. With the development of the Army Combat Fitness Test (ACFT), set to replace the Army Physical Fitness Test (APFT), it was a concern from Congress to the US public what would the impacts of this test change would be on the careers of service members. The female US Army Officer population was underrepresented in both the beta testing and in the development of the ACFT events. This survey investigated the perceptions of these women on individual event effectiveness and the ongoing revisions of the scoring systems. Overwhelmingly, this survey showed the efficacy of many of the events in which the desired targeted skills were not being evaluated and that a gender based scale was required so as not to have a biased or unfair test of physical abilities.

Context: Hispanic/Latino adults are at a higher risk of developing type 2 diabetes mellitus compared to non-Hispanic white adults. Regular physical activity can help reduce the risk of developing chronic conditions such as diabetes mellitus and obesity. Standard prevention programs have not shown the same level of effectiveness in the Hispanic/Latino population. Objective: The purpose of this systematized review was to evaluate the recent literature of physical activity interventions in the Hispanic/Latino population that may lead to an increase in physical activity and reduce long-term health risks. Design: A systematized review of recent published articles utilizing physical activity interventions in the Hispanic/Latino community. This included seven articles that were published in the past five years. Eligibility Criteria: Hispanic/Latino adults who have not been diagnosed with diabetes mellitus, but who may have certain risk factors such as pre-diabetes or obesity. Study Selection: Sources searched were PUBMED and CINAHL. These sources were searched between December 2023 and February 2024. The search yielded 1,298 citations without duplicates. The inclusion criteria included studies in which the populations were entirely Hispanic or Latino adults, with an intervention that included the promotion of physical activity and was conducted in Spanish. Main Outcome Measures: Increasing physical activity and decreasing risk factors, such as elevated hemoglobin A1c, body mass index (BMI), body fat percentage, and body weight. Results: Most researchers reported an increased engagement in physical activity with their interventions. The approaches to engage participants and the end points varied in the individual studies. Researchers reported significant increases in “leisure walking” (p=0.46) or “brisk walking” (p=0.011), which also resulted in decreased sedentary time. Researchers also reported an increased likelihood of achieving Centers for Disease Control and Preventio

The aim of this study was to address the need to improve ways of encouraging individuals who are living with prediabetes to increase their daily consumption of fruits and vegetables. In order to address this problem, the study explored a strategy that could serve as motivation and skill-building in people who are living with prediabetes. The first part of the strategy was to provide participants with weekly allotments of fresh fruits and vegetables. In addition to providing fresh fruits and vegetables, the second part of the strategy allowed participants to experience a food demonstration highlighting a healthy recipe using one or two of the fresh fruits and vegetables. The strategy was implemented along with a weekly curriculum from a “lifestyle change program” led by a trained coach (CDC, 2021e). To evaluate the impact of the strategy, dietary consumption surveys were collected from individuals enrolled in the CDC-recognized lifestyle change program in two different cohorts (a control group and intervention group) located in Southwest Virginia over an eighteen-week period. Both groups responded to a survey regarding their fruit and vegetable consumption and the data was analyzed for the relationship between fruit and vegetable access and skill-building food demonstrations and consumption of fruit and vegetables. The results could assist diabetes instructors and coaches in developing program components to implement with their clients who are living with prediabetes to encourage behavior changes around meeting the recommended daily consumption of fruits and vegetables.

This study examined Virginia Tech female collegiate athletes’ knowledge and perspectives of nutrition and its relationship to sports performance. Although various studies have examined the nutritional knowledge of collegiate athletes, the knowledge and perspectives of athletes on the value of nutrition to their performance needs further study. This current study aims to investigate the nutrition knowledge and perspectives relating to athletic performance of Virginia Tech female collegiate athletes through structured interviews using a literature-based interview guide, and to assess the dietary actions and sources of nutrition information in this population. A total of ten student-athletes participated in the interview process via Zoom. Social Cognitive Theory (SCT) served as the theoretical framework for development of the interview questions and analysis of responses. Content analysis of transcribed interviews was conducted using a hybrid deductive and inductive approach. Information from the interviews fell into four broad themes related to nutrition and athletic performance, focus on balance, schedule considerations, planning ahead, and terminology confusion. This study found female collegiate athletes from Virginia Tech showed a lack of understanding of nutrition as it relates to athletic performance. Despite the fact that respondents think nutrition has a significant impact on sports performance, these participants only gave nutrition a partial significance in their daily lives.

This study aimed to explore how vertical jump height, as a measure of fatigue, was affected throughout the pre-season training period in women’s division I collegiate soccer. The participants of this study completed three consecutive countermovement jumps with the hands placed on the hips before and after each day of training, throughout a five-day pre-season training period. Participants were placed into one of three groups based on the total minutes of match play each athlete experienced (>60 minutes, 30-60 minutes or <30 minutes). Athletes in the >60 minutes group experienced a larger reduction in vertical jump height than those in the other two groups. The type of training each group participated in following matches one and two was dependent upon the number of match play minutes, as the high minute group participated in a recovery-based training session following each match played. The effects of these group-specific training plans were reflective in the vertical jump heights as there was an increase in jump height for the >60 minutes group and a decrease in height for the 30-60 minutes and the <30 minutes groups. Vertical countermovement jump height was shown to reflect the fatigue experienced by division I collegiate women’s soccer players throughout a pre-season training time-period, as reductions in jump height were found amongst high-minute athletes following match play and amongst low-minute athletes following more demanding training sessions.

Lumbar disc herniations are one of the most common back injuries. Distal radiculopathies are common complications that accompany disc herniations, but in the case of this 19-year-old male collegiate cheerleader, his symptoms did not resolve with normal rehabilitation and healing time. His immediate treatment plan included traditional Mckenzie extension protocol with sciatic nerve glides as well as erector spinae, glute, and quadratus lumborum soft tissue releases for eight weeks, followed by two epidural steroid injections during his third month post-injury. Corrective strengthening exercises that targeted his core, glutes, and back muscles were completed for a total of twelve months, with a short break during the summer between academic years. He is currently seventeen months post-injury and can complete all activities of daily living (ADLs) without issue and only experiences small limitations when asked to hip hinge with a straight leg during activity. This case study aims to educate current and future orthopedic professionals about potential disc herniation complications and the treatment plan that helped this athlete live comfortably again.

To date, there has been limited research about the nutritional quality of school lunches during the COVID-19 pandemic. This analysis compared the nutritional profile of grab-and-go take-home lunches compared to standard lunches provided during in-person class instruction once normal schedules and school meals resumed at one elementary school. The study included two school lunch menus: 1) – one menu for take-home school lunches retained from January 2021 (COVID-19 lunches); and one lunch menu the school system’s standard food distributor from January 2023 (standard lunches). The nutritional content of the COVID-19 meals was analyzed using Food Processor nutrition software. Both lunch menus were analyzed for macronutrients – carbohydrates, cholesterol, fats, fiber, protein, and sugar along with micronutrients- calcium, potassium, sodium, iron, and vitamin D. A Mann Whitney U tests were used to compare differences between two independent groups – COVID-19 lunches and standard lunches. The Bonferroni adjustment was a post hoc adjustment used to decrease type I error. The COVID-19 meal entrees contained more iron than the standard lunch. For standard meals, the fruit groups contained more iron. The COVID-19 meal’s milk group contained significantly more total fat and vitamin D than the standard lunches. In the total meals, the only significant difference was a higher level of calcium in the COVID-19 take-home meals compared to standard meals. This analysis indicates school meals served during COVID-19 were nutritionally equivalent to standard meals, in spite of limitations with packaging lunches, supply side issues, etc. Additional research is warranted with larger sample sizes to provide broader insight into USDA school meals during COVID-19 and potential impacts on youth benefiting from these meals.

Although athletes decide to go to college ultimately to get an education, the importance of athletic performance to D1 college athletes and coaches cannot be looked over. Coaches and athletes across the country are looking for the most effective way to prepare and train to optimize athletic performance. New technology such as Whoop wearable devices, are leading the way, helping athletes optimize training and recovery to increase athletic performance. The main purpose of this pilot study was to explore the feasibility and applicability of Whoop technology in D1 college wrestlers. Specifically, the aims were to look at relationships between different Whoop biofeedback indicators and relationships between Whoop indicators and variables such as mood states, hydration status, and vertical jump height as a measure of performance. 9 male D1 college wrestlers (age: 21.2 ± 1.20) wore a Whoop strap every day and night except during competition, for 6 weeks during in-season training. The Whoop strap measured recovery percentage, heart rate variability (HRV), resting heart rate (RHR), sleep, and strain (from training and other physical demands) daily. Participants also completed the profile of mood states (POMS) questionnaire and a vertical jump test once weekly. At the conclusion of the study, participants completed the BEVQ-15 survey indicating their fluid intake habits over the course of the previous 30 days. At the conclusion of the data collection phase, 9 out of 10 participants had enough viable data to use for analysis. Additionally, multiple participants reported that they still use the Whoop device even after the conclusion of the study to continue managing their training and recovery. A 90% compliance rate and continued use of the Whoop technology points to its feasibility and applicability for college wrestlers. Results found that recovery, as measured by the Whoop, was positively associated with HRV and sleep, but negatively associated with RHR (p<0.0001, p<0.0001

Chronic traumatic encephalopathy (CTE) is progressive degeneration of the brain that has been found in multiple case reports of American football athletes. A major predictor of CTE are subconcussive head impacts. Repetitive head impacts that do not result in signs or symptoms of a concussion have been termed ‘subconcussive head impacts.’ Researchers have begun to identify characteristics of subconcussive head impacts experienced during football (e.g., amount, force, speed, and direction of impacts), but to date, changes in these characteristics have not been described over the course of a full collegiate football season. In addition, research on the effects of subconcussive head impacts on neurocognitive performance is inconsistent. Neurocognitive performance is defined as the capability to think and reason through concentration, recall, learning, and processing information. Therefore, in this study we aimed to describe subconcussive head impacts experienced by American football athletes throughout a full collegiate season, and to evaluate the effect of a full season of subconcussive head impacts on neurocognitive performance through the assessment of complex brain activities, or cognition. National Collegiate Athletic Association (NCAA) Division I Football athletes from two programs served as participants (n=39, age 20.4+1.6 years). The data to describe subconcussive head impacts were collected through an accelerometer that attached to the participants’ helmets during all practices and games. The assessment of cognition was conducted through a testing battery, the Cambridge Neuropsychological Test Automated Battery (CANTAB). We found that over the course of one full season, participants experienced a mean of 824.5 head impacts at varying forces. Performance on assessments of memory, reaction time, and flexible thinking decreased from the start of the season to the end of the season. In addition, participants who experienced a higher amount of head impacts and who e

This study aimed to determine if an acute bout of exercise could improve academic performance when compared to sedentary behavior within a 2-hour window before a college exam. The participants of this study completed two bouts of an intervention on two separate occasions, exercise and sedentary, then completed each of the two class exams, followed by a short survey to gain insight on motivation and anxiety. A 2-way ANOVA was used to determine a time or group effect as this study was completed over a 15-week semester and found no significant difference between the group’s exam scores over time, as well as no group effect of the acute bout of exercise on their exam performance. Pre- and post-surveys, as well as post-exam surveys collected data relating to IPAQ, MSLQ, and GRIT which found significant correlations between IPAQ and perceived exam preparedness with P=0.041. As expected in academia, each exam’s scores were positively related to final course grades with P=0.0275 on exam 1 and P=0.0179 on exam 2. Finally, a P=0.048 was found between final course grades and scores from the extrinsic motivations section of the MSLQ on the post-study survey. Results and lessons learned from this pilot study should be used towards creating a larger-scale study in the future.

The purpose of this project was to implement and evaluate a pilot referral process between Carilion Healthcare System and Virginia Cooperative Extension for the Balanced Living with Diabetes Program. Both institutions expressed interest and need for this system, and the Plan, Do, Study, Act tool was utilized to carry this project. Through the creation of a core team from both institutions, with communication via email and virtual meeting platforms, a compliant fax referral form was developed to relay referral information and to achieve synergy across both the healthcare and community organizations, with the goal of developing a model that would increase access and utilization of community-based services by individuals who have a type 2 diabetes diagnosis. This pilot referral process was conducted from March – July, 2022 with multiple programs in place for implementation. During the mid-project review, no referrals had been received. In response to no referrals, program rack cards were then distributed to two Carilion Family Medicine Practices as an additional strategy for referrals. Overall, the limited timeframe for this project was a barrier for complete facilitation. Both institutions worked well together in this pilot study and plan to continue the referral process after the completion of this project.

As of 2021, 38.3 million people lived in food-insecure households in the United States (USDA, 2021c). Nutrition-related health inequities may be exacerbated by limited consumer access to nutrient-dense foods (Ver Ploeg, M., et. al., 2009). Farmers’ markets (FMs) give consumers direct access to locally-grown produce, as well as meats, eggs, and dairy products directly to consumers (Wetherill, M. S., & Gray, K. A. 2015). However, farmers’ markets are not utilized equally by all demographic groups. When markets use electronic benefits transfer (EBT) for the Supplemental Nutrition Assistance Program (SNAP), Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) benefits, and the Senior Farmers' Market Nutrition Program, increased marketing targeting low-income and minority consumers can connect these populations to affordable produce. (Wetherill, M. S., & Gray, K. A. 2015). There are limited research studies involving equitable communications through farmers’ markets, particularly in Virginia. Through this project, a farmers’ market communication guide for SNAP-eligible audiences was created to help facilitate farmers’ market managers and/or other farmers’ market outreach coordinators in developing inclusive messages for SNAP-eligible populations through communications, advertisements, and other outreach strategies.

FADS1 is a key regulator of fatty acid metabolism with important implications for athlete health and performance. Mutations in the FADS1 gene have been linked to a variety of adverse health conditions, in addition to alterations in biochemical levels of fatty acids. Polyunsaturated fatty acids, including omega-3 and omega-6 fatty acids, are associated with rates of inflammation, immune function, and brain health in athletes. The purpose of this study was to explore the relationship between genetic variability, specifically in the FADS1 gene, and fatty acid metabolism in an athletic population. Methods: 20 collegiate football players were recruited for this study. Saliva samples were collected for the purpose of obtaining genetic information. Serum samples for ALA, AA, EPA, and DHA were collected to measure omega-3 and omega-6 fatty acid levels. Genotypes and serum measurements were compared using 3x3 Fisher Exact tests, and the online software PROVEAN was used to identify potential novel variants in the FADS1 gene. Results of this exploratory study suggest the minor allele for 9 variants in the FADS1 gene decrease baseline serum levels of EPA. These results suggest that genetic data may be useful in assessing individual athlete risk for n-3 PUFA deficiency and associated health consequences. Subsequently, this may allow athletes and sports practitioners to make better informed decisions about individual intake and supplementation of n-3 PUFAs, specifically, EPA and DHA.

Prior work suggests that actual, but not estimated, energy density drives the reinforcing value of food and that energy from fat and carbohydrate can interact to potentiate reward. Here we sought to replicate these findings in an American sample and to determine if the effects are influenced by body mass index (BMI). Thirty participants with healthy weight (HW; BMI 21.92 ± 1.77; M ± SD) and 30 participants with overweight/obesity (OW/OB; BMI 29.42 ± 4.44) rated pictures of common American snacks in 120-kcal portions for liking, familiarity, frequency of consumption, expected satiety, healthiness, energy content, energy density, and price. Participants then completed an auction task where they bid for the opportunity to consume each food. Snacks contained either primarily carbohydrate, primarily fat, or roughly equal portions of fat and carbohydrate (combo). Replicating prior work, we found that participants with HW bid the most for combo foods in linear mixed model analyses. This effect was not observed among individuals with OW/OB. Additionally, in contrast with previous reports, our linear regression analyses revealed a negative relationship between the actual energy density of the snacks and bid amount that was mediated by food price. Our findings support altered macronutrient reinforcement in obesity and highlight potential influences of the food environment on the regulation of food reward.

Dance has traditionally been viewed from a Eurocentric perspective as a mode of self-expression that involves the human body moving through space, performed for the purposes of art, and viewed by an audience. In this Hypothesis and Theory article, we synthesize findings from anthropology, sociology, psychology, dance pedagogy, and neuroscience to propose The Synchronicity Hypothesis of Dance, which states that humans dance to enhance both intra- and inter-brain synchrony. We outline a neurocentric definition of dance, which suggests that dance involves neurobehavioral processes in seven distinct areas including sensory, motor, cognitive, social, emotional, rhythmic, and creative. We explore The Synchronicity Hypothesis of Dance through several avenues. First, we examine evolutionary theories of dance, which suggest that dance drives interpersonal coordination. Second, we examine fundamental movement patterns, which emerge throughout development and are omnipresent across cultures of the world. Third, we examine how each of the seven neurobehaviors increases intraand inter-brain synchrony. Fourth, we examine the neuroimaging literature on dance to identify the brain regions most involved in and affected by dance. The findings presented here support our hypothesis that we engage in dance for the purpose of intrinsic reward, which as a result of dance-induced increases in neural synchrony, leads to enhanced interpersonal coordination. This hypothesis suggests that dance may be helpful to repattern oscillatory activity, leading to clinical improvements in autism spectrum disorder and other disorders with oscillatory activity impairments. Finally, we offer suggestions for future directions and discuss the idea that our consciousness can be redefined not just as an individual process but as a shared experience that we can positively influence by dancing together.

For years, the consumption of a diet rich in fruits and vegetables has been considered healthy, increasing longevity, and decreasing morbidities. With the assistance of basic research investigating the potential mechanisms, it has become clear that the beneficial effects of plant-based foods are mainly due to the large amount of bioactive phenolic compounds contained. Indeed, substantial dietary intervention studies in humans have supported that the supplementation of polyphenols have various health-promoting effects, especially in the elderly population. In vitro examinations on the anti-aging mechanisms of polyphenols have been widely performed, using different types of natural and synthetic phenolic compounds. The aim of this review is to critically evaluate the experimental evidence demonstrating the beneficial effects of polyphenols on aging-related diseases. We highlight the potential anti-aging mechanisms of polyphenols, including antioxidant signaling, preventing cellular senescence, targeting microRNA, influencing NO bioavailability, and promoting mitochondrial function. While the trends on utilizing polyphenols in preventing aging-related disorders are getting growing attention, we suggest the exploration of the beneficial effects of the combination of multiple polyphenols or polyphenol-rich foods, as this would be more physiologically relevant to daily life.

Objective: The immediate signals that couple exercise to metabolic adaptations are incompletely understood. Nicotinamide adenine dinucleotide phosphate oxidase 4 (Nox4) produces reactive oxygen species (ROS) and plays a significant role in metabolic and vascular adaptation during stress conditions. Our objective was to determine the role of Nox4 in exercise-induced skeletal muscle metabolism. Methods: Mice were subjected to acute exercise to assess their immediate responses. mRNA and protein expression responses to Nox4 and hydrogen peroxide (H2O2) were measured by qPCR and immunoblotting. Functional metabolic flux was measured via ex vivo fatty acid and glucose oxidation assays using C-14-labeled palmitate and glucose, respectively. A chronic exercise regimen was also utilized and the time to exhaustion along with key markers of exercise adaptation (skeletal muscle citrate synthase and beta-hydroxyacyl-coA-dehydrogenase activity) were measured. Endothelial-specific Nox4-deficient mice were then subjected to the same acute exercise regimen and their subsequent substrate oxidation was measured. Results: We identified key exercise-responsive metabolic genes that depend on H2O2 and Nox4 using catalase and Nox4-deficient mice. Nox4 was required for the expression of uncoupling protein 3 (Ucp3), hexokinase 2 (Hk2), and pyruvate dehydrogenase kinase 4 (Pdk4), but not the expression of peroxisome proliferator-activated receptor gamma coactivator 1-alpha (Pgc-1 alpha). Global Nox4 deletion resulted in decreased UCP3 protein expression and impaired glucose and fatty acid oxidization in response to acute exercise. Furthermore, Nox4-deficient mice demonstrated impaired adaptation to chronic exercise as measured by the time to exhaustion and activity of skeletal muscle citrate synthase and beta-hydroxyacyl-coA-dehydrogenase. Importantly, mice deficient in endothelial-Nox4 similarly demonstrated attenuated glucose and fatty acid oxidation following acute exercise. Conclusions: W

Ovarian cancer is the deadliest gynecological cancer in women, with a survival rate of less than 30% when the cancer has spread throughout the peritoneal cavity. Aggregation of cancer cells increases their viability and metastatic potential; however, there are limited studies that correlate these functional changes to specific phenotypic alterations. In this study, we investigated changes in mitochondrial morphology and dynamics during malignant transition using our MOSE cell model for progressive serous ovarian cancer. Mitochondrial morphology was changed with increasing malignancy from a filamentous network to single, enlarged organelles due to an imbalance of mitochondrial dynamic proteins (fusion: MFN1/OPA1, fission: DRP1/FIS1). These phenotypic alterations aided the adaptation to hypoxia through the promotion of autophagy and were accompanied by changes in the mitochondrial ultrastructure, mitochondrial membrane potential, and the regulation of reactive oxygen species (ROS) levels. The tumor-initiating cells increased mitochondrial fragmentation after aggregation and exposure to hypoxia that correlated well with our previously observed reduced growth and respiration in spheroids, suggesting that these alterations promote viability in non-permissive conditions. Our identification of such mitochondrial phenotypic changes in malignancy provides a model in which to identify targets for interventions aimed at suppressing metastases.

Drugs of abuse induce persistent remodeling of reward circuit function, a process thought to underlie the emergence of drug craving and relapse to drug use. However, how circuit-specific, drug-induced molecular and cellular plasticity can have distributed effects on the mesolimbic dopamine reward system to facilitate relapse to drug use is not fully elucidated. Here, we demonstrate that dopamine receptor D3 (DRD3)-dependent plasticity in the ventral pallidum (VP) drives potentiation of dopamine release in the nucleus accumbens during relapse to cocaine seeking after abstinence. We show that two distinct VP DRD3(+) neuronal populations projecting to either the lateral habenula (LHb) or the ventral tegmental area (VTA) display different patterns of activity during drug seeking following abstinence from cocaine self-administration and that selective suppression of elevated activity or DRD3 signaling in the LHb-projecting population reduces drug seeking. Together, our results uncover how circuit-specific DRD3-mediated plasticity contributes to the process of drug relapse.

The Pan American Health Organization (PAHO) Strategic Plan 2020–2025 committed to reduce children’s consumption of energy-dense nutrient-poor food and beverage products high in fat, sugar and salt (HFSS) and promote healthy eating patterns to reduce malnutrition in all forms. This paper describes the capacity-building needs in PAHO’s Member States to restrict the marketing of HFSS food and beverages to children. We asked Ministries of Health officials or national institutes/departmental representatives (n = 35) to complete a 28-item web-based survey (January to July 2020). Capacity-building needs were assessed using an adapted version of the World Health Organization’s government capacity-building framework with three modules: public health infrastructure, policies and information systems. Notable achievements for the PAHO’s Plan of Action were identified. State representatives reported strong infrastructure and information systems; however, policy improvements are needed to increase comprehensive national responses. These include using a constitutional health and human rights approach within the policies, policies that document conflict of interest from non-state actors, and strengthening regulatory oversight for digital media platforms. These findings provide baseline data and we suggest priorities for further action to strengthen national governments’ capacity-building and to accelerate the development, implementation, and monitoring systems to restrict the marketing of HFSS food and non-alcoholic beverages to children in the region of the Americas.

The United States (U.S.) Department of Agriculture (USDA)-administered Supplemental Nutrition Assistance Program (SNAP) made substantial changes in response to the coronavirus disease 2019 (COVID-19) pandemic. These changes highlight the need to identify the digital literacy skills and capacities of SNAP adults to purchase healthy groceries online. We conducted a scoping review of four electronic databases, Google and Google Scholar to identify studies that measured food and nutrition literacy outcomes for U.S. adults. We applied a multi-dimensional digital food and nutrition literacy (MDFNL) model to assess six literacy levels and components. Of 18 studies published from 2006–2021, all measured functional and interactive literacy but no study measured communicative, critical, translational, or digital literacy. Six studies examined SNAP or SNAP-Education outcomes. Adults with higher food or nutrition literacy scores had better cognitive, behavioral, food security and health outcomes. We suggest how these findings may inform research, policies, and actions to strengthen the multi-dimensional literacy skills of SNAP participants and SNAP-eligible adults to support healthy purchases in the online food retail ecosystem.

The accumulation of damaged mitochondria due to insufficient autophagy has been implicated in the pathophysiology of skeletal muscle aging. Ulk1 is an autophagy-related kinase that initiates autophagosome assembly and may also play a role in autophagosome degradation (i.e., autophagy flux), but the contribution of Ulk1 to healthy muscle aging is unclear. Therefore, the purpose of this study was to investigate the role of Ulk1-mediated autophagy in skeletal muscle aging. At age 22 months (80% survival rate), muscle contractile and metabolic function were assessed using electrophysiology in muscle-specific Ulk1 knockout mice (MKO) and their littermate controls (LM). Specific peak-isometric torque of the ankle dorsiflexors (normalized by tibialis anterior muscle cross-sectional area) and specific force of the fast-twitch extensor digitorum longus muscles was reduced in MKO mice compared to LM mice (p < 0.03). Permeabilized muscle fibers from MKO mice had greater mitochondrial content, yet lower mitochondrial oxygen consumption and greater reactive oxygen species production compared to fibers from LM mice (p ≤ 0.04). Alterations in neuromuscular junction innervation patterns as well as changes to autophagosome assembly and flux were explored as possible contributors to the pathological features in Ulk1 deficiency. Of primary interest, we found that Ulk1 phosphorylation (activation) to total Ulk1 protein content was reduced in older muscles compared to young muscles from both human and mouse, which may contribute to decreased autophagy flux and an accumulation of dysfunctional mitochondria. Results from this study support the role of Ulk1-mediated autophagy in aging skeletal muscle, reflecting Ulk1′s dual role in maintaining mitochondrial integrity through autophagosome assembly and degradation.

Physical activity has profound acute effects on the body and brain, causing a cascade of beneficial physiological and psychological processes to occur. Dance, a multidimensional form of physical activity, has shown similar positive effects in long-term studies, but no studies to date have looked at the relationship between mental health and social outcomes of dance. In March of 2020, the quarantine that took place due to COVID-19 caused a sense of social isolation, lack of physical connection, and increased mental health issues. In this study, we explore the hypothesis that online dance can acutely improve mental health and connection during a time of isolation. N=47 healthy adults completed a series of self-reported Qualtrics questionnaires before and after a single 60- minute online dance session. Data were analyzed using paired-samples t-tests, Pearson's correlations, and linear regressions. Online dance acutely improved mental health by increasing positive affect and self-esteem while decreasing negative affect and depression. Social and community connectedness were also enhanced, with those who experienced the largest decreases in negative affect demonstrating the largest gains in social connectivity. Further, an individual’s trait learning style influenced class efficacy, with tactile learners benefitting the most in mood state and visual learners benefitting the most socially. Finally, we found that greater levels of experienced enjoyment improved mood state, whereas greater levels of perceived difficulty resulted in increased anxiety. We suggest best practices for online dance, provide future areas of research, and highlight the importance of using online learning to increase dance accessibility to diverse populations.

Interventions to discourage sugary beverages and encourage water consumption have produced modest and unsustainable behavioral changes to reduce obesity and noncommunicable disease risks. This systematic scoping review examined media campaigns to develop a typology to support healthy hydration nonalcoholic beverage behaviors. Our three-step methodology included the following: (1) review and summarize expert-recommended healthy beverage guidelines; (2) review six English-language electronic databases guided by PRISMA to describe existing campaign types by issue, goal and underlying theory; and (3) develop a media campaign typology to support policies, systems and environments to encourage healthy hydration behaviors. Results showed no international consensus for healthy beverage guidelines, though we describe expert-recommended healthy beverage guidelines for the United States. Of 909 records identified, we included 24 articles describing distinct media campaigns and nine sources that defined models, schemes or taxonomies. The final media campaign typology included: (1) corporate advertising, marketing or entertainment; (2) corporate social responsibility, public relations/cause marketing; (3) social marketing; (4) public information, awareness, education/ health promotion; (5) media advocacy/countermarketing; and (6) political or public policy. This proof-of-concept media campaign typology can be used to evaluate their collective impact and support for a social change movement to reduce sugary beverage health risks and to encourage healthy hydration behaviors.

Alcohol and caffeine, when consumed in excessive amounts, may negatively impact performance, health, and well-being. Nevertheless, college athletes have been shown to commonly consume these substances at a high level despite numerous interventions in place to moderate intake. The goal of this pilot project was to explore the role of biofeedback in monitoring and influencing alcohol and caffeine consumption among collegiate athletes. Twelve female NCAA Division I collegiate softball athletes (age: 19.1 ± 1.3; race: Caucasian/Non-Hispanic n=11,) wore a WHOOP® strap non-stop for 60 days to measure resting heart rate (RHR), heart rate variability (HRV), recovery (calculated from HRV, RHR, and hours of sleep), sleep, and energy (kcals) expended. Subjects also completed a brief daily survey regarding alcohol and caffeine intake during the previous 24 hours. At the end of the 60-day period, subjects participated in a semi-structured interview regarding their perception of the impact of wearing the WHOOP® strap on health-related behaviors. Overall, subjects consumed alcohol on 19.2±6.0% of days, at a rate of 1.0±0.7 servings of alcohol per day (range: 0 to 14 servings). Caffeine intake was 100.3±75.9 mg of caffeine per day. Alcohol intake was negatively associated with next-day and weekly recovery % (r=-0.304, p<0.001 and r=-0.576, p=0.02 respectively), sleep % (r=-0.286, p<0.001 and r= -0.434, p= 0.04) respectively), HRV (r=-0.251, p=<0.001 and r= -0.530, p= 0.029 respectively), and kcals expended (r=-0.213, p<0.001 and r= -0.528, p= 0.029 respectively), and was positively associated with next-day RHR (r=0.333, p<0.001). Caffeine intake was positively associated with weekly RHR (r= 0.653, p= 0.010) and negatively associated with next-day and weekly HRV (r=-0.079, p=0.034 and r= -0.500, p= 0.034 respectively), but not with any other measure. Eight of the twelve subjects perceived that the WHOOP® strap influenced their behavior in some way (sleep: n=6, caffeine: n=3, alcohol

In July 2018, the United States Department of Housing and Urban Development (HUD) implemented a mandatory smoke-free rule in public housing. This study assessed administrator and resident perceptions of rule implementation during its initial year in the District of Columbia Housing Authority (DCHA). Assessment included nine focus groups (n = 69) with residents and in-depth interviews with administrators (n = 7) and residents (n = 26) from 14 DCHA communities (family = 7 and senior/disabled = 7). Semi-structured discussion guides based on the multi-level socio-ecological framework captured dialogue that was recorded, transcribed verbatim, and coded inductively. Emerging major themes for each socio-ecological framework level included: (1) Individual: the rule was supported due to perceived health benefits, with stronger support among non-smokers; (2) Interpersonal: limiting secondhand smoke exposure was perceived as a positive for vulnerable residents; (3) Organizational: communication, signage, and cessation support was perceived as a need; (4) Community: residents perceived mobility, disability, weather, and safety-related issues as barriers; and (5) Public Policy: lease amendments were perceived as enablers of rule implementation but expressed confusion about violations and enforcement. A majority of administrators and residents reported favorable implications of the mandated HUD rule. The novel application of a socio-ecological framework, however, detected implementation nuances that required improvements on multiple levels, including more signage, cessation support, clarification of enforcement roles, and addressing safety concerns.

Heat stress (HS) diminishes animal production, reducing muscle growth and increasing adiposity, especially in swine. Excess heat creates a metabolic phenotype with limited lipid oxidation that relies on aerobic and anaerobic glycolysis as a predominant means of energy production, potentially reducing metabolic rate. To evaluate the effects of HS on substrate utilization and energy expenditure, crossbred barrows (15.2 ± 2.4 kg) were acclimatized for 5 days (22 °C), then treated with 5 days of TN (thermal neutral, 22 °C, n = 8) or HS (35 °C, n = 8). Pigs were fed ad libitum and monitored for respiratory rate (RR) and rectal temperature. Daily energy expenditure (DEE) and respiratory exchange ratio (RER, CO2:O2) were evaluated fasted in an enclosed chamber through indirect calorimetry. Muscle biopsies were obtained from the longissimus dorsi pre/post. HS increased temperature (39.2 ± 0.1 vs. 39.6 ± 0.1 °C, p < 0.01) and RER (0.91 ± 0.02 vs. 1.02 ± 0.02 VCO2:VO2, p < 0.01), but decreased DEE/BW (68.8 ± 1.7 vs. 49.7 ± 4.8 kcal/day/kg, p < 0.01) relative to TN. Weight gain (p = 0.80) and feed intake (p = 0.84) did not differ between HS and TN groups. HS decreased muscle metabolic flexibility (~33%, p = 0.01), but increased leucine oxidation (~35%, p = 0.02) compared to baseline values. These data demonstrate that HS disrupts substrate regulation and energy expenditure in growing pigs.

Great teachers are continually introducing strategies to engage students, especially those who teach large-lecture classes, whose format can limit active learning and student motivation to engage in learning. Implementation of active teaching strategies must be assessed for effectiveness. Using the simple MUSIC model postcourse assessment survey, student motivation to engage in learning was statistically quantified. A simple short intervention of in-class group work led to significant areas of improvement, which included the students’ perception of the class’ Usefulness towards their future career (p <.01), their perceived ability for Success in the class (p <.01), their Interest in the material (p <.01), and their perception of the instructor Caring about their success (p <.05). No change was seen in eMpowerment. In addition, students rated the ease of the class (p <.01) and the overall satisfaction with the course (p <.01) significantly higher than the previous semester, prior to the in-class group work implementation. The implementation of this short simple intervention of in-class group work was highly successful in increasing student motivation in a large-lecture, in-major required exercise and health class and can be easily adapted to other large-lecture classes.

Background: Probiotic supplements have shown the potential to reduce gastrointestinal (GI) distress symptoms; however, there is currently little research on dietary probiotic intake or the impact of probiotic food consumption on GI symptoms, particularly among athletes. Purpose: The purpose of this project was to: 1) develop and evaluate a tool for assessing intake of probiotic foods among collegiate athletes, 2) assess intake of probiotic and fermented foods among collegiate athletes at Virginia Tech, and 3) explore associations between intake of these items and GI symptoms in this study population. Methods: A literature review, review of 360 dietary recalls previously collected from collegiate athletes (n=120), and evaluation by five experts in sports nutrition and/or probiotic foods informed the development of a brief probiotic food frequency questionnaire (PRO-Q). The PRO-Q was then administered to participants (n=42), all of whom were members of Division I sports teams at Virginia Tech. Validity was assessed by comparing PRO-Q responses with probiotic intake determined using three 24-hour diet recalls (reference method). Participants also completed a questionnaire to evaluate type and severity of GI symptoms. Results: Overall intake of probiotic/fermented foods in this population was low (0.77 servings/day), with only 17% of participants reporting daily consumption. Based on Spearman’s Rho (r=0.766, p<0.001), Wilcoxon Signed-Rank test (p=0.168, indicating no difference between methods), and Bland-Altman analyses (95% agreement), PRO-Q responses were consistent with dietary recalls for average daily intake of probiotic/fermented foods. A total of 52% of participants reported experiencing regular GI distress symptoms. There was no association between PRO-Q responses and overall GI symptom score (r = 0.297, p = 0.056). Conclusion: These findings suggest that among collegiate athletes, probiotic/fermented food intake was generally low and GI distress symptoms were

This project examined the accuracy of blog sources personal trainers in Jeffrey’s Bay, South Africa use to educate themselves on the topic of intermittent fasting. Through literature review, different types of intermittent fasting were researched such as time-restricted feeding, periodic fasting, and alternate day fasting as well as the role intermittent fasting plays in weight loss and modifying risk factors for health conditions such as obesity and cardiovascular disease. A small convenience sample of five personal trainers were used to conduct one-on-one semi-structured interviews in a local gym to determine what sources of information they use to educate themselves on intermittent fasting and if they use any blog sources. The top three blog sources were determined based on frequency of mention and manual deductive qualitative coding was applied to blog articles from each blog source in order to determine accuracy of information in two key criteria: timing of feeding and fasting, and instructions on caloric intake. The third criteria, type of references used in each blog article, was recorded and combined with accuracy of the other two criteria to calculate an average reliability score. Accuracy in both timing of feeding and fasting, and instructions on caloric intake fell between 86 and 100%, for the three blog sites, and the average reliability scores fell between 85 and 95%. Another component of this project focused on a qualitative evaluation regarding statements of health benefits made in each blog article as well as the type of reference used to substantiate each health benefit claim based on a hierarchy of scientific evidence.1 There were sixty seven total unique health benefit claims made in the articles from all three blog sources. One hundred percent of those claims had cited references justifying each claim. Forty three percent of the cited references were either Meta analyses and systematic reviews or randomized controlled trials. The findings show th

Nutrition during pregnancy has lifelong impacts on the health of mother and child. However, this life stage presents unique challenges to healthy cooking and eating. Cooking interventions show promising results, but often lack theoretical basis and rigorous evaluation. The objective of this formative, qualitative study was to explore motivators, strategies, and barriers related to healthy cooking during pregnancy. Pregnant individuals’ preferences for a cooking education program were also explored. We conducted five focus groups with pregnant individuals (n = 20) in Southeast Michigan in 2019. Focus groups were audio-recorded and transcribed verbatim, then double coded by two members of the research team. Mean gestational age was 18.3 ± 9.6 weeks. Common motivators included feeding other children, avoiding pregnancy complications, promoting fetal growth, and avoiding foodborne illness. Challenges included pregnancy symptoms, navigating nutrition recommendations, mental energy of meal planning, family preferences, and time constraints. Strategies employed were meal planning and including a variety of foods. Participants identified organizational strategies, recipes, nutrition information, and peer support as important components of a cooking intervention during pregnancy. This study characterized multiple challenges to healthy home cooking during pregnancy, providing novel insight to inform the development of cooking skills education programs during this important life stage.

There are few return-to-activity protocols and functional tests specifically designed for a proximal hamstring rupture for athletic trainers to follow when clearing an athlete for return to activity. To address this problem, the purpose of this study is to describe and evaluate a return to activity protocol that includes functional testing for a post-surgical proximal hamstring rupture to assess readiness for return to activity. This case study collected data from a 20-year-old, 6ft 2in, 185lb (87.9 kg) collegiate heptathlete that ruptured his proximal hamstring that required surgical treatment. The student athlete’s (SA) return to activity process is evaluated and explained. The SA went through numerous function tests to determine return to activity status. The first testing session was conducted 8 months post-surgery. He was then re-assessed 4 months later. During testing, the SA also wore accelerometers to gather more quantitative data to identify gait abnormalities due to the injury. The first round of testing revealed greater strength in his left (affected) leg compared to his right (unaffected) leg. The SA was not able to complete all the tests during the first round of testing due to muscular fatigue and soreness, suggesting low muscular endurance at that point in time. Thus, he was not cleared to return to activity and continued to do rehabilitation exercises to increase the endurance of the hamstring muscles. The second round of testing was completed 4 months later which revealed that he had gained endurance in the hamstring muscles and his strength had increased. At this point, he was cleared for full return to activity. This return-to-activity protocol with specific functional tests could serve as a template for other athletic trainers who are seeking to return an athlete to full activity after suffering a proximal hamstring rupture (See Appendix I).

In 2010, 193 Member States of the World Health Organization (WHO) endorsed World Health Assembly Resolution WHA63.14 to restrict the marketing of food and beverage products high in fat, sugar and salt (HFSS) to children to prevent obesity and non-communicable diseases (NCDs). No study has examined HFSS marketing policies across the WHO regional office countries in the Americas. Between 2018 and 2019, a transdisciplinary team examined policies to restrict HFSS food and beverage product marketing to children to develop a responsible policy index (RESPI) that provides a quality score based on policy characteristics and marketing techniques. After designing the RESPI, we conducted a comprehensive literature review through October 2019 to examine policies in 14 countries in the WHO Americans Region. We categorized policies (n = 38) as either self-regulatory or statutory and calculated the RESPI scores, ranked from 0 (lowest) to 10 (highest). Results showed Brazil, Canada, Chile, and Uruguay had the highest RESPI scores associated with statutory policies that restricted point of sale, cartoon, licensed media characters and celebrities; and HFSS products in schools and child care settings, and broadcast and print media. Policymakers can use the RESPI tool to evaluate marketing policies within and across geopolitical boundaries to protect children’s diet and health.

The COVID-19 pandemic is having major economic and personal consequences for collegiate and professional sports. Sporting events have been canceled or postponed, and even when baseball and basketball seasons resumed in the United States recently, no fans were in attendance. As play resumed, several players developed COVID-19, disrupting some of the schedules. A hypothesis now under scientific consideration is that taking vitamin supplements to raise serum 25-hydroxyvitamin D [25(OH)D] concentrations could quickly reduce the risk and/or severity of COVID-19. Several mechanisms have been identified through which vitamin D could reduce the risks of infection and severity, death, and long-haul effects of COVID-19: (1) inducing production of cathelicidin and defensins to reduce the survival and replication of the SARS-CoV-2 virus; (2) reducing inflammation and the production of proinflammatory cytokines and risk of the “cytokine storm” that damages the epithelial layer of the lungs, heart, vascular system, and other organs; and (3) increasing production of angiotensin-converting enzyme 2, thus limiting the amount of angiotensin II available to the virus to cause damage. Clinical trials have confirmed that vitamin D supplementation reduces risk of acute respiratory tract infections, and approximately 30 observational studies have shown that incidence, severity, and death from COVID-19 are inversely correlated with serum 25(OH)D concentrations. Vitamin D supplementation is already familiar to many athletes and sports teams because it improves athletic performance and increases playing longevity. Thus, athletes should consider vitamin D supplementation to serve as an additional means by which to reduce risk of COVID-19 and its consequences.

Allen and Pennington et al. show that the cardiolipin-binding peptide elamipretide mitigates disease-induced fragmentation of cristae networks following cardiac ischemia reperfusion in rats. This study suggests that elamipretide targets mitochondrial membranes to sustain cristae networks, improving their bioenergetic function. Mitochondrial dysfunction contributes to cardiac pathologies. Barriers to new therapies include an incomplete understanding of underlying molecular culprits and a lack of effective mitochondria-targeted medicines. Here, we test the hypothesis that the cardiolipin-binding peptide elamipretide, a clinical-stage compound under investigation for diseases of mitochondrial dysfunction, mitigates impairments in mitochondrial structure-function observed after rat cardiac ischemia-reperfusion. Respirometry with permeabilized ventricular fibers indicates that ischemia-reperfusion induced decrements in the activity of complexes I, II, and IV are alleviated with elamipretide. Serial block face scanning electron microscopy used to create 3D reconstructions of cristae ultrastructure reveals that disease-induced fragmentation of cristae networks are improved with elamipretide. Mass spectrometry shows elamipretide did not protect against the reduction of cardiolipin concentration after ischemia-reperfusion. Finally, elamipretide improves biophysical properties of biomimetic membranes by aggregating cardiolipin. The data suggest mitochondrial structure-function are interdependent and demonstrate elamipretide targets mitochondrial membranes to sustain cristae networks and improve bioenergetic function.

Recent studies revealed that relatively small changes in perfusate sodium ([Na+](o)) composition significantly affect cardiac electrical conduction and stability in contraction arrested ex vivo Langendorff heart preparations before and during simulated ischemia. Additionally, [Na+](o) modulates cardiomyocyte contractility via a sodium-calcium exchanger (NCX) mediated pathway. It remains unknown, however, whether modest changes to [Na+](o) that promote electrophysiologic stability similarly improve mechanical function during baseline and ischemia-reperfusion conditions. The purpose of this study was to quantify cardiac mechanical function during ischemia-reperfusion with perfusates containing 145 or 155 mM Na+ in Langendorff perfused isolated rat heart preparations. Relative to 145 mM Na+, perfusion with 155 mM [Na+](o) decreased the amplitude of left-ventricular developed pressure (LVDP) at baseline and accelerated the onset of ischemic contracture. Inhibiting NCX with SEA0400 abolished LVDP depression caused by increasing [Na+](o) at baseline and reduced the time to peak ischemic contracture. Ischemia-reperfusion decreased LVDP in all hearts with return of intrinsic activity, and reperfusion with 155 mM [Na+](o) further depressed mechanical function. In summary, elevating [Na+](o) by as little as 10 mM can significantly modulate mechanical function under baseline conditions, as well as during ischemia and reperfusion. Importantly, clinical use of Normal Saline, which contains 155 mM [Na+](o), with cardiac ischemia may require further investigation.

Background There is a need to unpack the empirical, practical, and personal challenges within participatory approaches advocated to optimize implementation. The unpredictable, chaotic nature of participatory approaches complicates application of implementation theories, methods, and strategies which do not address researchers’ situatedness within participatory processes. As an implementation scientist, addressing one’s own situatedness through critical reflection is important to unearth how conscious and unconscious approaches, including ontological and epistemological underpinnings, influence the participatory context, process, and outcomes. Therefore, the aim of this exploratory work is to investigate the heretofore blind spot toward the lived experience of implementation researchers within the participatory process. Methods We developed an integrated research-practice partnership (IRPP) to inform the implementation of a gestational weight gain (GWG) control program. Within this IRPP, one investigator conducted a 12-month autoethnography. Data collection and triangulation included field notes, cultural artifacts, and systematic timeline tracking. Data analysis included ethnographic-theoretical dialogue and restorying to synthesize key events and epiphanies into a narrative. Results Analysis revealed the unpredicted evolution of the GWG program into a maternal health fair and three themes within the researchers’ lived experience: (1) permeable work boundaries, (2) individual and collective blind spots toward the ontological and epistemological underpinnings of implementation paradigms, and (3) maladaptive behaviors seemingly reinforced by the research culture. These themes contributed to the chaos of implementation and to researchers’ experience of inadequate recovery from cognitive, emotional, and practical demands. These themes also demonstrated the importance of contextual factors, subjectivity, and value-based judgments within implementation research. Conclusio

Objective: To describe relationships among baseline characteristics, engagement indicators and outcomes for rural participants enrolled in SIPsmartER, a behavioural intervention targeting sugar-sweetened beverage (SSB) intake. Design: A secondary data analysis. Bivariate analyses determined relationships among baseline characteristics (e.g. age, gender, race, education, income), engagement indicators (completion of 6-month health screening, class attendance, call completion) and SSB outcomes (SSB ounce reduction (i.e. US fluid ounces; 1 US fl. oz = 29 center dot 57 ml), reduced >= 12 ounces, achieved <= 8 ounce intake). Generalized linear models tested for significant effects of baseline characteristics on engagement indicators and of baseline characteristics and engagement indicators on SSB outcomes. Setting: South-west Virginia, USA, a rural, medically underserved region. Participants: Participants' (n 155) mean age was 41 years; most were female (81 %), White (91 %) and earned <=$US 20 000 per annum (61 %). Results: All final models were significant. Engagement models predicted 12-17 % of variance, with age being a significant predictor in all three models. SSB outcome models explained 5-70 % of variance. Number of classes attended was a significant predictor of SSB ounce reduction (beta = -6 center dot 12, P < 0 center dot 01). Baseline SSB intake significantly predicted SSB ounce reduction (beta = -0 center dot 90, P < 0 center dot 001) and achieved <= 8 ounce intake (beta = 0 center dot 98, P < 0 center dot 05). Conclusions: The study identifies several participant baseline characteristics that may impact engagement in and outcomes from a community-based intervention targeting SSB intake. Findings suggest greater attendance of SIPsmartER classes is associated with greater reduction in overall SSB intake; yet engagement variables did not predict other outcomes. Findings will inform the future implementation of SIPsmartER and research studies of similar design a

Eating disorders and disordered eating have a prevalence of 6% to 45% in collegiate female athletes (Knapp, Aerni, & Anderson, 2014). Thin idealization and body image dissatisfaction are risk factors for the development of disordered eating and eating disorders. Dissonance-based prevention programs have been shown to be effective in reducing thin idealization and body image dissatisfaction, as well as lessening risk of developing disordered eating and eating disorders. Currently, Virginia Tech Athletics does not utilize a group-based eating disorder prevention program for its female athletes. The purpose of this pilot project was to administer the Body Project, a dissonance-based prevention program aimed at reducing thin idealization and body image dissatisfaction, to female swimmers at Virginia Tech and evaluate the program’s effect on thin idealization and body image dissatisfaction. Thin idealization and body image dissatisfaction were evaluated via the Body Parts Satisfaction Survey-Revised (BPSS-R) and the Ideal Body Stereotype Survey-Revised (IBSS-R), respectively, before and after completion of the Body Project. Ten female swimmers, without current eating disorders, volunteered to participate, and nine swimmers (19.44 ± 1.42 years old; 5 freshmen, 2 juniors, and 2 seniors) completed the full project. Sixty-seven percent of participants (6 out of 9) experienced a reduction in their subscription to thin-ideal internalization (IBSS-R 2.96 ± 0.92 pre, 1.85 ± 0.88 post, p<0.05), while 78% of participants (7 out of 9) experienced an increase in body satisfaction (BPSS-R 4.42 ± 1.35 pre, 5.08 ± 0.90 post, p<0.05, p< 0.05). The findings of this pilot project suggest that the Body Project is an effective tool to influence subscription to thin-ideal internalization and body satisfaction in female college athletes. Continued effort to refine and implement the Body Project as group-based eating disorder prevention program for female college athletes is needed.

Colorectal cancer is the third leading cause of cancer death in the USA, yet is highly preventable and detectable at an early stage through screening. Virginia Cooperative Extension (VCE) implemented a worksite colon cancer awareness program to increase colorectal cancer screening rates and preventive lifestyle behaviors among its employees. The Colon Cancer-Free Zone program is designed using best practice principles of worksite health programs and includes information sessions covering the topics of colorectal cancer, screening guidelines, insurance coverage, and preventive lifestyle behaviors. It is conducted in a campaign format that includes a strategic communication strategy targeting relevant screening barriers and facilitators, peer champions, and incentives. The program was implemented with VCE employees statewide utilizing a web-based system for the information sessions, and resulted in broad participation, a significant increase in screening self-efficacy (4.15 +/- 0.64 vs 3.81 +/- 0.76, rho = 0.006), changes in diet and physical activity (50% and 40% of participants, respectively), and a 20.6% increase in the employee colorectal cancer screening rate. A Colon Cancer-Free Zone toolkit was developed for use by Extension Agents to implement the program at worksites in their service communities.

Alzheimer’s disease is a debilitating and life-altering diagnosis that continues to rise each year, as our population continues to live longer. While there is currently no proven cure for the disease, there are proactive measures that can be taken to delay or prevent onset of the disease. The Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet is a compilation of foods that work synergistically to promote the prevention of Alzheimer’s Disease (AD). The specific amount and types of foods in this diet promote the reduction of inflammation and oxidative stress in the body, thus preventing or delaying onset of AD. While there is evidence to support the use of the MIND diet as a long-term approach to prevent AD, this diet is currently not being administered in healthcare settings in the United States. This study explores the factors affecting implementing the MIND diet in an acute care setting. Working within the transtheoretical model of behavior change, a foodservice organization is examined in regard to their readiness to change and willingness to adopt this diet into their facilities. Their willingness to adopt the MIND diet was determined by a series of interviews held via email, phone call, and in person. The organization deemed the MIND diet inappropriate for the acute care setting because of the short length of stay of patients, budgetary restraints, and patient preferences. While the MIND diet was deemed inappropriate for effective use in this environment, there are multiple other settings that should be explored in future research. The MIND diet is most beneficial when adhered to for a long duration, therefore, introducing the diet in a setting where the population is exposed for longer be most beneficial. Example of these settings include daycares, schools, long-term care facilities, senior living centers, or assisted living facilities.

Community-based participatory research is an approach to creating research in partnership between communities and researchers (see Israel, Eng, Schulz, & Parker, 2012; Wallerstein, Duran, Oetzel, & Minkler, 2018). An integral part of the process is action to address community-identified needs. Our team implemented the SEED Method in a rural Virginia community to address an issue of great concern to the community: high rates of opioid misuse and overdoses. The opioid crisis was already a focus of concern in the community, and there were ongoing efforts to address it. Community stakeholders, who knew about a previous project completed by our community-based participatory research (CBPR) team using the SEED Method, asked if we could start a project on the opioid issue in their community. Our previous work using this method focused on developing and prioritizing research questions, but we knew that community members wanted to develop strategies and potential solutions. Here we describe an adaptation of the SEED Method that occurs in two parts. Part I focuses on working with diverse community stakeholders to develop and prioritize potential strategies for addressing the health problem. Part II brings together stakeholders to develop and implement community action plans based on those strategies. The process resulted in a list of potential strategies developed by stakeholder participants. In two subsequent community action planning meetings, stakeholders selected four of these strategies and formed four work groups for the action phase of planning and implementation.

Digital marketing is widely used to promote highly processed food and beverage products with excessive energy and high in fat, sugars and salt (HFSS) to young people, negatively impacting their diet and health. In this paper, we describe the global trends in digital marketing used to promote unhealthy HFSS products to children, adolescents and young adults aged 7 to 24 years. We review the digital privacy policies of 18 major transnational firms — six technology and 12 international food and beverage companies — to promote food and beverage products, brands and healthy and sustainable lifestyles to young people. Our analysis shows that four of the six technology firms have privacy-protection policies for children under 13 years, but that no firm has a digital marketing policy to restrict the targeting of HFSS food and beverage products to young people. Only one of the 12 food and beverage companies studied has publicly pledged not to use digital marketing to promote HFSS food and beverage products to adolescents (aged 13–18). Governments must develop comprehensive privacy-protection laws that restrict firms from using digital marketing to promote HFSS products to young people and only allow products that meet healthy nutrient-profile criteria. Global and national actors should encourage these 18 firms to adopt best practices to use digital marketing to support healthy and sustainable diets, lifestyles and food systems for future generations.

This commentary describes insights from Star Trek's fictional television series to understand how state and non-state actors address conflicts of interest (COIs) through global nutrition governance. I examine the findings of Ralston and colleagues for 44 state and non-state actors who responded to the World Health Organization's (WHO's) consultation for a COI risk-assessment tool, developed for member states to engage effectively with non-state actors to address malnutrition in all forms. Star Trek reveals that actor engagement is inevitable in a shared universe. The Prime Directive is a non-interference principle reflecting a moral commitment to reduce harm, respect autonomy and protect rights. Engagement principles are relevant to all actors who influence nutrition policies and programs, and must be held accountable when their actions undermine healthy and sustainable food systems. Certain actors use COI to justify non-engagement with commercial actors yet competing interests, biases, corruption and regulatory capture are distinct challenges to manage. Finally, Star Trek's characters serve as allegories to understand actors' motives and actions to promote healthy and sustainable food systems. Unlike non-state actors, states are legally required to achieve their commitments and targets in the United Nations' (UN) Decade of Action on Nutrition (2016-2025) and Sustainable Development Goals (SDGs) 2030 Agenda.

Older adults are frequently cited as an at-risk population for vitamin D deficiency that may in part be due to decreased cutaneous synthesis, a potentially important source of cholecalciferol (vitamin D3). Previous studies found that cutaneous D3 production declines with age; however, most studies have been conducted ex vivo or in the photobiology lab. The purpose of this study was to characterize the response of vitamin D metabolites following a 30-min bout of sun exposure (15-min each to the dorsal and ventral sides) at close to solar noon in younger and older adults. Methods: 30 healthy individuals with skin type II/III were recruited; a younger cohort, aged 20–37 (n = 18) and an older cohort (n = 12), age 51–69 years. Exposure was at outer limits of sensible sun exposure designed to enhance vitamin D synthesis without increasing risk of photo ageing and non-melanoma skin cancer. Serum D3 concentration was measured at baseline, 24, 48 and 72 h post-exposure. Serum 25(OH)D was measured at baseline and 72 h post-exposure plus 168 h post-exposure in the older cohort. Results: D3 increased in response to sun exposure (time effect; p = 0.002) with a trend for a difference in D3 between cohorts (time*group; p = 0.09). By regression modeling of continuous data, age accounted for 20% of the variation in D3 production. D3 production decreased by 13% per decade. Despite changes in D3, however, serum 25(OH)D did not change from baseline to 72 or 168 h post exposure (p > 0.10). Conclusions: Serum D3 concentration increased significantly in response to outdoor sun exposure in younger and older adults. While ageing may dampen cutaneous synthesis, sunlight exposure is still a significant source of vitamin D3.

Obesity and insulin resistance are risk factors for nonalcoholic fatty liver disease (NAFLD), the most common chronic liver disease worldwide. Because no approved medication nor an accurate and noninvasive diagnosis is currently available for NAFLD, there is a clear need to better understand the link between obesity and NAFLD. Lipid accumulation during obesity is known to be associated with oxidative stress and inflammatory activation of liver macrophages (LMs). However, we show that although LMs do not become proinflammatory during obesity, they display signs of oxidative stress. In livers of both humans and mice, antioxidant nuclear factor erythroid 2– related factor 2 (NRF2) was down-regulated with obesity and insulin resistance, yielding an impaired response to lipid accumulation. At the molecular level, a microRNA-targeting NRF2 protein, miR-144, was elevated in the livers of obese insulin-resistant humans and mice, and specific silencing of miR-144 in murine and human LMs was sufficient to restore NRF2 protein expression and the antioxidant response. These results highlight the pathological role of LMs and their therapeutic potential to restore the impaired endogenous antioxidant response in obesity-associated NAFLD.