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Background Grip strength has prognostic value for aging-related health outcomes. Whether the associations of grip strength with the risk of dementia and Alzheimer's disease (AD) vary by the genetic risk of AD and related dementias (ADD) is unknown. Methods This study included 148 659 older adults of white British ancestry (aged ≥60 years) participating in UK Biobank with no dementia, and self-reported poor health status at baseline. Polygenic risk scores (PRS) for ADD were calculated based on 64 genetic variants. Grip strength was measured by hand dynamometers. Results The hazard ratios (HR) of dementia (n  = 4 963) and AD (n  = 2 373) for high genetic risk of ADD were 2.36 (95% confidence interval [CI]: 2.15–2.59) and 3.00 (95% CI: 2.61–3.44), respectively, compared with low genetic risk. Compared with the bottom tertile of grip strength, the top tertile of grip strength had a hazard ratio (HR) of 0.69 (95% CI: 0.64–0.74) for incident dementia, and 0.74 (95% CI: 0.66–0.82) for incident AD, after adjustment for confounders and PRS for ADD. The risk of dementia and AD was lower with the top grip strength tertile within each level of genetic susceptibility to ADD. There was no evidence of multiplicative interaction between grip strength and genetic susceptibility to ADD for both dementia (p value:.241) and AD (p value:.314). Conclusions Older adults with higher PRS for ADD are at higher risk of developing dementia and AD. The risk of dementia and AD was lower in individuals with higher grip strength, regardless of their level of genetic susceptibility to ADD. [ABSTRACT FROM AUTHOR]

Background: Excess sedentary time (ST) is recognized as an important modifiable risk factor for coronary heart disease (CHD). However, whether the associations of genetic susceptibility with CHD incidence can be modified by replacing wearable‐device‐measured ST with physical activity (PA) is unknown. Objectives: To examine the associations of wearable‐device‐measured ST replaced by PA with incident CHD across strata of genetic susceptibility. Methods: This study included 77,500 White British (57% female) with valid wrist‐worn accelerometry and without prevalent CHD/stroke from UK Biobank. Genetic susceptibility to CHD was quantified through weighted polygenic risk scores for CHD based on 300 single‐nucleotide polymorphisms. Wrist‐worn accelerometer data were used to derive ST, light PA, and moderate‐to‐vigorous PA (MVPA). Results: Reallocation of 60 min/day of ST into the same amount of MVPA was associated with approximately 9% lower relative risk of CHD for all participants and across strata of genetic risk: replacement of 1 min/day of ST associated with <1% lower relative risk of CHD. No evidence of interaction (p: 0.784) was found between genetic risk and ST for CHD risk. Reallocating 60 min/day of ST into the same MVPA time was associated with greater absolute CHD risk reductions at high genetic risk (0.27%) versus low genetic risk (0.15%). Conclusions: Replacing any amount of ST with an equal amount of MVPA time is associated with a lower relative risk of CHD, irrespective of genetic susceptibility to CHD. Reductions in CHD absolute risk for replacing ST with MVPA are greater at high genetic risk versus low genetic risk. [ABSTRACT FROM AUTHOR]

Purpose: Remifentanil is useful in balanced anesthesia; however, there is concern regarding opioid-induced hyperalgesia. The effect of remifentanil on rebound pain, characterized by hyperalgesia after peripheral nerve block has rarely been studied. This study evaluated whether intraoperative remifentanil infusion may increase postoperative analgesic requirement in patients receiving preoperative interscalene brachial plexus block (IBP). Methods: Sixty-eight patients undergoing arthroscopic shoulder surgery under general anesthesia were randomly allocated to remifentanil (R) or control (C) group. Preoperative IBP with 0.5% ropivacaine 15 mL was performed in all patients. Intraoperative remifentanil was administered only in the R group. Postoperative pain was controlled using intravenous patient-controlled analgesia (IV-PCA) and rescue analgesics. The primary outcome was the dosage of fentanyl-nefopam IV-PCA infused over 24 h postoperatively. The secondary outcomes included the numeric rating scale (NRS) score recorded at 4-h intervals over 24 h, amount of rescue analgesics and total postoperative analgesics used over 24 h, occurrence of intraoperative hypotension, postoperative nausea and vomiting (PONV) and delirium. Results: The dosage of fentanyl-nefopam IV-PCA was significantly less in C group than R group for postoperative 24 h. Fentanyl 101 [63–158] (median [interquartile range]) µg was used in the C group, while fentanyl 161 [103–285] µg was used in the R group (median difference 64 µg, 95% CI 10–121 µg, P = 0.02). Nefopam 8.1 [5.0–12.6] mg was used in the C group, while nefopam 12.9 [8.2–22.8] mg was used in the R group (median difference 5.1 mg, 95% CI 0.8–9.7 mg, P = 0.02). The total analgesic consumption: the sum of PCA consumption and administered rescue analgesic dose, converted to morphine milligram equivalents, was higher in the R group than C group (median difference 10.9 mg, 95% CI 3.0–19.0 mg, P = 0.01). The average NRS score, the incidence of PONV and delirium, were similar in both groups. The incidence of intraoperative hypotension was higher in R group than C group (47.1% vs. 20.6%, P = 0.005). Conclusions: Remifentanil administration during arthroscopic shoulder surgery in patients undergoing preoperative IBP increased postoperative analgesic consumption. [ABSTRACT FROM AUTHOR]

Background: Whether the associations of time spent in screen-based sedentary activities with CHD vary by genetic susceptibility is currently unknown. The objective of this study was to examine the interplay of genetic susceptibility to CHD and two prevalent types of screen-based sedentary activities (television [TV] viewing and computer use) for CHD incidence.Methods: This prospective cohort study included 373,026 individuals of European ancestry without prevalent CHD/stroke from UK Biobank data. Genetic susceptibility to CHD was assessed using weighted polygenic risk scores, calculated by summing the number of risk-increasing alleles among 300 single-nucleotide polymorphisms, multiplied by their corresponding effect estimates. TV viewing and computer use were assessed through touch-screen questionnaires. CHD incidence (n=9185) was adjudicated over a median 12.6-year follow-up.Results: Compared with ≥4h/day of TV viewing, the hazard ratio of CHD was 0.84 (95% confidence interval [CI] 0.79-0.90) and 0.94 (0.90-0.99) for ≤1h/day and 2-3h/day of TV viewing, respectively, after adjusting for confounders including the genetic risk. CHD hazards were higher for medium and high genetic risk than for low genetic risk. Across all levels of genetic risk including high-genetic risk, ≤1h/day of TV viewing had lower CHD hazards, compared with ≥4h/day: no evidence of interaction between genetic risk and TV viewing (p value: 0.362). Estimates of the population attributable fraction (PAF) suggested that 10.9% (95% CI 6.1-15.3%) of CHD could be prevented if TV viewing time were reduced to ≤1h/day, assuming causality. The PAF values were relatively larger for medium-to-high genetic risk than for low genetic risk, although the CIs were wide and overlapping. No associations were observed for computer use.Conclusions: Less TV viewing time was associated with lower CHD risk independently of genetic risk. Clinical trials targeted at individuals with high genetic susceptibility should consider reducing TV viewing as as a behavioural target for prevention of an early onset of cardiovascular events. [ABSTRACT FROM AUTHOR]

Background: Spondylolisthesis is a common degenerative spinal deformity. At the level of spondylolisthesis, the anatomy of the interlaminar space may differ from normal spine, in which case optimal angle of the needle insertion for spinal anesthesia may change. This study compared the optimal angle of needle insertion during spinal anesthesia in patients with and without lumbar spondylolisthesis using ultrasound. Methods: We recruited 40 patients, 20 with and 20 without lumbar spondylolisthesis (group S and N, respectively). Ultrasonography was performed in the transverse midline and parasagittal oblique views at the spondylolisthesis level and the adjacent upper level. We measured the probe application angle with the longest interlaminar height of the ligamentum flavum-dura mater complex (LFD), depth from the skin to the LFD, depth from the skin to the anterior complex, and intrathecal space width. A positive angle represented a cephalad angulation. Results: The optimal needle insertion angle in the transverse midline view at the spondylolisthesis level was (-) 2.7 ± 3.4° in group S and 0.8 ± 2.5° in group N (P < 0.001). In the parasagittal oblique view, it was (-) 2.7 ± 4.5° in group S and 1.0 ± 3.2° in group N (P = 0.004). There were no between-group differences in the angles at the upper level, with all cephalad angles in both views. Other ultrasound image data were comparable between groups. Conclusion: In patients with spondylolisthesis, caudad angulation of the spinal needle can aid successful spinal puncture at spondylolisthesis level, both in the midline and paramedian approaches. Trial registration: www.ClinicalTrials.gov (NCT04426916); registered 11 June 2020. [ABSTRACT FROM AUTHOR]

Microphysiological system (MPS) is a powerful tool for the in vitro disease validation platform. It is employed to substantially enhance understanding of tumor and their microenvironments. It aims to assist or replace preclinical studies for validating the efficacy of anti-cancer drugs, precision medicine, and investigating metastatic mechanisms. However, it still faces formidable challenges due to poor and complex usability, low yield, and limited applications for heterogeneous biological samples. Herein, we present a newly developed MPS consisting of a binary tumor-microenvironment-on-a-chip. The system is divided into two independent and separate MPS, each capable of forming a different compartment for the tumor and microenvironment via concurrent processing. These individually formed compartments can be interconnected whenever needed through simple mechanical compression, resulting in a fully integrated tumor-microenvironment-on-a-chip system. This interconnected system enables precise validation of drug efficacy and can be easily separated to retrieve the finished reaction sample for further downstream analysis. In this study, we also propose anisotropic tumor remission by forced convection phenomenon. • Binary tumor-microenvironment-on-a-chip can independently develop each organ and reconnect. • It is possible to retrieve finished biological reaction samples for downstream analysis without damage. • Remission of the 3D tumor spheroid was observed anisotropically through forced convection. [ABSTRACT FROM AUTHOR]

COVID-19 led to social isolation that may have compromised adolescent mental health. This study examined the independent and joint associations of aerobic physical activity (PA) and muscle-strengthening exercise (MSE) with mental health problems in adolescents. Participants were US adolescents who completed the 2015–2021 National Youth Risk Behavior Survey (N = 61,298; 45.7% female). Data were collected between 2015 and 2021 and analyzed in 2023. Outcomes were binary response items asking about feeling sad/hopeless, having difficulty concentrating, remembering, or making decisions, and having a suicidal ideation. Preventive exposure variables were items asking about frequencies of aerobic PA and MSE with responses dichotomized to align with recommendations. Independent and joint associations were examined using robust Poisson regression with covariates selected using double selection lasso. Structural equation models examined the associations treating PA and MSE as continuous predictors and poor mental health as a latent dependent variable. Meeting either recommendation alone associated with a 4–10% lower prevalence of mental health problems (APR = 0.90–0.96, p < 0.05), and meeting both recommendations associated with a 15%–20% lower prevalence of mental health problems (APR = 0.80–0.85, p < 0.001). Although categorical joint associations were stronger in males (p < 0.05), multiplicative interactions were observed in females using continuous variables for PA and MSE (β = −0.09, p < 0.001). Meeting aerobic PA and MSE recommendations associated with lower prevalence of mental health problems. Participation in MSE below recommended levels may be beneficial for females when combined with aerobic PA. Future research should examine these associations by acquiring contextual information and device-based assessments. • Aerobic PA or MSE associated with lower prevalence of sadness or hopelessness. • Aerobic PA or MSE associated with lower prevalence of difficulty making decisions. • Joint aerobic PA and MSE associated with a lower prevalence of suicidal ideation. • Joint aerobic PA and MSE more strongly associated with fewer mental health problems. • Future research should examine these joint associations below recommended levels. [ABSTRACT FROM AUTHOR]

Background: Recent advances in sensor technologies have promoted the use of consumer-based accelerometers such as Fitbit Flex in epidemiological and clinical research; however, the validity of the Fitbit Flex in measuring sedentary behavior (SED) and physical activity (PA) has not been fully determined against previously validated research-grade accelerometers such as ActiGraph GT3X+. Therefore, the purpose of this study was to examine the concurrent validity of the Fitbit Flex against ActiGraph GT3X+ in a free-living condition.Methods: A total of 65 participants (age: M = 42, SD = 14 years, female: 72%) each wore a Fitbit Flex and GT3X+ for seven consecutive days. After excluding sleep and non-wear time, time spent (min/day) in SED and moderate-to-vigorous PA (MVPA) were estimated using various cut-points for GT3X+ and brand-specific algorithms for Fitbit, respectively. Repeated measures one-way ANOVA and mean absolute percent errors (MAPE) served to examine differences and measurement errors in SED and MVPA estimates between Fitbit Flex and GT3X+, respectively. Pearson and Spearman correlations and Bland-Altman (BA) plots were used to evaluate the association and potential systematic bias between Fitbit Flex and GT3X+. PROC MIXED procedure in SAS was used to examine the equivalence (i.e., the 90% confidence interval with ±10% equivalence zone) between the devices.Results: Fitbit Flex produced similar SED and low MAPE (mean difference [MD] = 37 min/day, P = .21, MAPE = 6.8%), but significantly higher MVPA and relatively large MAPE (MD = 59-77 min/day, P < .0001, MAPE = 56.6-74.3%) compared with the estimates from GT3X+ using three different cut-points. The correlations between Fitbit Flex and GT3X+ were consistently higher for SED (r = 0.90, ρ = 0.86, P < .01), but weaker for MVPA (r = 0.65-0.76, ρ = 0.69-0.79, P < .01). BA plots revealed that there is no apparent bias in estimating SED.Conclusion: In comparison with the GT3X+ accelerometer, the Fitbit Flex provided comparatively accurate estimates of SED, but the Fitbit Flex overestimated MVPA under free-living conditions. Future investigations using the Fitbit Flex should be aware of present findings. [ABSTRACT FROM AUTHOR]

The paper describes the combinatorial study of experimental and theoretical on organic-inorganic hybrid compound [(NH3-CH2-C(CH3)2-CH2-NH3)]2+[ZnCl4]2-. The molecular structure of the studied compound was optimized theoretically, and the quantum chemical parameters were calculated. The vibratory bands emerging in the FT-IR were accurately assigned by animated mode. Molecular properties like frontier orbitals analysis, chemical reactivity descriptors, MEP mapping, dipole moments and natural charges were calculated under the DFT using the B3LYP/6-311++G(d,p)/LanL2DZ theory level. The theoretical data are found to be in good correlation with the experimental results obtained from various physicochemical techniques. The agar diffusion methods were used to study the antimicrobial assay of the compound against pathogenic strains, namely Escherichia coli and Salmonella typhi bacteria as well as selected fungi species: Candida albicans, Aspergillus niger and Aspergillus flavus. It was observed that Zn-ionic salt compound was selective and acts as a competitive inhibitor on E. coli compared to other strains. Molecular docking simulation was carried out to predict the nature of hybrid compound in the X-ray crystal structure of receptor of E. coli (PDB ID: 1ERQ) at active site to find out the suitable binding modality. The results of the simulation acknowledged the inhibitor nature of a new an organic inorganic hybrid compound. Cytotoxicity was also assessed in terms of LD50 (lethal dose, 50%) using a brine shrimp lethality bioassay. Obtained brine shrimp lethality test results suggested that bioactive quality exists in the Zn compound which could be considered for its biological effects. [ABSTRACT FROM AUTHOR]

Introduction: Accurate tracking of physical activity (PA) and sedentary behavior (SB) is important to advance public health, but little is known about how to interpret wrist-worn accelerometer data. This study compares youth estimates of SB and moderate to vigorous PA (MVPA) obtained using raw and count-based processing methods.Methods: Data were collected between April and October 2014 for the National Cancer Institute's Family Life, Activity, Sun, Health, and Eating Study: a cross-sectional Internet-based study of youth/family cancer prevention behaviors. A subsample of 628 adolescents (aged 12-17 years) wore the ActiGraph GT3X+ on the wrist for 7 days. In 2015-2016, SB and MVPA time were calculated from raw data using R-package GGIR and from activity counts data using published cutpoints (Crouter and Chandler). Estimates were compared across age, sex, and weight status to examine the impact of processing methods on behavioral outcomes.Results: ActiGraph data were available for 408 participants. Large differences in SB and MVPA time were observed between processing methods, but age and gender patterns were similar. Younger children (aged 12-14 years) had lower sedentary time and greater MVPA time (p-values <0.05) than older children (aged 15-17 years), consistent across methods. The proportion of youth with ≥60 minutes of MVPA/day was highest with the Crouter methods (~50%) and lowest with GGIR (~0%).Conclusions: Conclusions about youth PA and SB are influenced by the wrist-worn accelerometer data processing method. Efforts to harmonize processing methods are needed to promote standardization and facilitate reporting of monitor-based PA data. [ABSTRACT FROM AUTHOR]

Introduction: This study describes the calibration and validity of the Youth Activity Profile (YAP) for use in the National Cancer Institute's Family Life, Activity, Sun, Health, and Eating (FLASHE) study. The calibrated YAP was designed to estimate minutes of moderate to vigorous physical activity (MVPA) and sedentary behavior (SB).Methods: The YAP was calibrated/validated in adolescents (aged 12-17 years) using cross-sectional data from the FLASHE study. Participants wore a GT3X+ ActiGraph on the dominant wrist for 7 days and then completed the YAP. Calibration was conducted for school (n=118); out of school (n=119); weekend (n=61); and SB (n=116) subsections of the YAP and by regressing percentage time in MVPA/SB (%MVPA/%SB) on each respective YAP subsection score, age, and the interaction between these two. The final algorithms were applied to independent samples (n=39-51) to examine validity (median absolute percentage error, equivalence testing).Results: The final algorithms explained 15% (school); 16% (out of school); and 12% (weekend) of the variability in GT3X+ %MVPA and 7% of the variability in GT3X+ %SB. The calibrated algorithms were applied to independent samples and predicted GT3X+ minutes of MVPA/SB, with median absolute percentage error values ranging from 12.5% (SB section) to 32.5% (weekend section). Predicted values obtained from the YAP were within 10%-20% of those produced by the GT3X+.Conclusions: The YAP-predicted minutes of MVPA/SB resulted in similar group estimates obtained from an objective measure. The YAP offers good utility for large-scale research projects to characterize PA/SB levels among groups of youth. [ABSTRACT FROM AUTHOR]

Sedentary behaviour (SB) has emerged as a modifiable risk factor, but little is known about measurement errors of SB. The purpose of this study was to determine the validity of 24-h Physical Activity Recall (24PAR) relative to SenseWear Armband (SWA) for assessing SB. Each participant (n = 1485) undertook a series of data collection procedures on two randomly selected days: wearing a SWA for full 24-h, and then completing the telephone-administered 24PAR the following day to recall the past 24-h activities. Estimates of total sedentary time (TST) were computed without the inclusion of reported or recorded sleep time. Equivalence testing was used to compare estimates of TST. Analyses from equivalence testing showed no significant equivalence of 24PAR for TST (90% CI: 443.0 and 457.6 min · day–1) relative to SWA (equivalence zone: 580.7 and 709.8 min · day–1). Bland–Altman plots indicated individuals that were extremely or minimally sedentary provided relatively comparable sedentary time between 24PAR and SWA. Overweight/obese and/or older individuals were more likely to under-estimate sedentary time than normal weight and/or younger individuals. Measurement errors of 24PAR varied by the level of sedentary time and demographic indicators. This evidence informs future work to develop measurement error models to correct for errors of self-reports. [ABSTRACT FROM PUBLISHER]

Purpose: The purpose of the study was to examine the accuracy of inclinometer functions of the ActiGraph GT3X+ (AG) (worn on the waist and wrist) and the activPAL (AP) in assessing time spent sitting, standing, and stepping.Methods: A total of 62 adults (age: 18-40 yrs; male:37; female:25) wore three activity monitors (AG waist, and AG wrist, and AP) while completing 15 different types of activities. The 15 activities were classified into 3 different postures (sitting, standing, and stepping) based on the directly observed behaviors. Minutes estimated from the inclinometers of the three monitors were directly compared to those from direct observation (criterion method) using mean absolute percent error (MAPE) values, effect sizes (Cohen's D), and equivalence testing.Results: The AP was more accurate than the both waist- and wrist-worn AG in both sitting and standing activities, but the AG was more accurate than the AP in stepping activity when the stepping activity was determined with 0.7 step/s threshold. Equivalence testing indicated that the time measured by the waist-, wrist-worn AG, and AP showed significant equivalence to the time in the equivalence zone (90% confidence interval: 2.7 to 3.3min) for 6, 5, and 7 activities, respectively.Conclusions: The AP was reasonably accurate for detecting sitting, standing, and stepping, and the AG was very accurate for classifying stepping when the stepping activity was determined by the formula created by 0.7 step/s threshold. It is expected that the result of the study would contribute to performing movement pattern analyses and health promotion research for classifying activities. [ABSTRACT FROM AUTHOR]

First, 65 over 68 patients had shoulder pain before operation. Effect of remifentanil on post-operative analgesic consumption in patients undergoing shoulder arthroplasty after interscalene brachial plexus block: a randomized controlled trial. Third, as described in method section, a bolus dose of intra-venous patient-controlled analgesic (IV-PCA) was allowed to be administered at a time when the patient required additional analgesic regardless of the NRS score. [Extracted from the article]

The treatment of [PdL 3 (NH 3 )](OTf) n ( n = 1; L 3 = (PEt 3 ) 2 (Ph), (2,6-(Cy 2 PCH 2 ) 2 C 6 H 3 ), n = 2; L 3 = (dppe)(NH 3 )) with NaNH 2 in tetrahydrofuran at ambient temperature or −78 °C afforded the dimeric and monomeric parent-amido palladium(II) complexes anti -[Pd(PEt 3 )(Ph)(μ-NH 2 )] 2 ( 1 ), [Pd(dppe)(μ-NH 2 )] 2 (OTf) 2 ( 2 ), and Pd(2,6-(Cy 2 PCH 2 ) 2 C 6 H 3 )(NH 2 ) ( 3 ), respectively. The molecular structures of the amido-bridged (μ-NH 2 ) dimeric complexes 1 and 2 were determined by single-crystal X-ray crystallography. The monomeric amido complex 3 reacted with trace amounts of water to give a hydroxo complex, Pd(2,6-(Cy 2 PCH 2 ) 2 C 6 H 3 )(OH) ( 4 ). Exposing complex 3 to an excess of water resulted in the complete conversion of the complex into two species [Pd(2,6-(Cy 2 PCH 2 ) 2 C 6 H 3 )(OH 2 )] + and [Pd(2,6-(Cy 2 PCH 2 ) 2 C 6 H 3 )(NH 3 )] + . Complex 3 reacted with diphenyliodonium triflate ([Ph 2 I]OTf) to give the aniline complex [Pd(2,6-(Cy 2 PCH 2 ) 2 C 6 H 3 )(NH 2 Ph)]OTf. The reaction of 3 with phenylacetylene (HC CPh) yielded a palladium(II) acetylenide Pd(2,6-(Cy 2 PCH 2 ) 2 C 6 H 3 )(C CPh) ( 5 ), quantitatively, along with the liberation of ammonia. The reaction of 3 with dialkyl acetylenedicarboxylate yielded diastereospecific palladium(II) vinyl derivatives ( Z )-Pd(2,6-(Cy 2 PCH 2 ) 2 C 6 H 3 )(CR CR(NH 2 )) (R = CO 2 Me ( 6a ), CO 2 Et ( 6b )). The reaction of complexes 6a and 6b with p -nitrophenol produced Pd(2,6-(Cy 2 PCH 2 ) 2 C 6 H 3 )(OC 6 H 4 - p -NO 2 ) ( 7 ) and cis -CHR CR(NH 2 ), exclusively. Reactions of 3 with either dialkyl maleate ( cis -(CO 2 R)CH CH(CO 2 R)) (R = CH 3 , CH 2 CH 3 ) or cis -stilbene ( cis -CHPh CHPh) did not result in any addition product. Instead, isomerization of the cis -isomers to the trans -isomers occurred in the presence of catalytic amounts of 3 . Complex 3 reacted with a stoichiometric amount of acrylonitrile (CH 2 CHCN) to generate a metastable insertion product, Pd(2,6-(Cy 2 PCH 2 ) 2 C 6 H 3 )(CH(CN)CH 2 NH 2 ). On the other hand, the reaction of 3 with an excess of acrylonitrile slowly produced polymeric species of acrylonitrile. The catalytic hydroamination of olefins with NH 3 was examined in the presence of Pd(2,6-(Cy 2 PCH 2 ) 2 C 6 H 3 )(OTf), producing a range of hydroaminated products of primary, secondary, and tertiary amines with different molar ratios of more than 99% overall yield. A mechanistic feature for the observed catalytic hydroamination is described with regard to the aminated derivatives of palladium(II). [ABSTRACT FROM AUTHOR]

Purpose: The study compares MET-defined cutpoints used to classify sedentary behaviors in children using a simulated free-living design.Methods: A sample of 102 children (54 boys and 48 girls; 7-13 years) completed a set of 12 activities (randomly selected from a pool of 24 activities) in a random order. Activities were predetermined and ranged from sedentary to vigorous intensities. Participant's energy expenditure was measured using a portable indirect calorimetry system, Oxycon mobile. Measured minute-by-minute VO2 values (i.e., ml/kg/min) were converted to an adult- or child-MET value using the standard 3.5 ml/kg/min or the estimated child resting metabolic rate, respectively. Classification agreement was examined for both the "standard" (1.5 adult-METs) and an "adjusted" (2.0 adult-METs) MET-derived threshold for classifying sedentary behavior. Alternatively, we also tested the classification accuracy of a 1.5 child-MET threshold. Classification accuracy of sedentary activities was evaluated relative to the predetermined intensity categorization using receiver operator characteristic curves.Results: There were clear improvements in the classification accuracy for sedentary activities when a threshold of 2.0 adult-METs was used instead of 1.5 METs (Se1.5 METs = 4.7%, Sp1.5 METs = 100.0%; Se2.0 METs = 36.9%, Sp2.0 METs = 100.0 %). The use of child-METs while maintaining the 1.5 threshold also resulted in improvements in classification (Se = 45.1%, Sp = 100.0%).Conclusion: Adult-MET thresholds are not appropriate for children when classifying sedentary activities. Classification accuracy for identifying sedentary activities was improved when either an adult-MET of 2.0 or a child-MET of 1.5 was used. [ABSTRACT FROM AUTHOR]

The treatment of [PdL 3 (NH 3 )]OTf (L 3 = (PEt 3 ) 2 (Ph) ( 1 ), (2,6-(Cy 2 PCH 2 ) 2 C 6 H 3 ) ( 3 )) with NaNH 2 in THF afforded dimeric and monomeric parent-amido palladium(II) complexes with bridging and terminal NH 2 , respectively, anti -[Pd(PEt 3 )(Ph)(μ-NH 2 )] 2 ( 2 ) and Pd(2,6-(Cy 2 PCH 2 ) 2 C 6 H 3 )(NH 2 ) ( 4 ). The dimeric complex 2 crystallizes in the space group P 2 1 / n with a = 13.228(2) Å, b = 18.132(2) Å, c = 24.745(2) Å, β = 101.41(1)°, and Z = 4. It has been found that there are two crystallographically independent molecules with Pd(1)–Pd(2) and Pd(3)–Pd(4) distances of 2.9594 (10) and 2.9401(9) Å, respectively. The monomeric amido complex 4 protonates from trace amounts of water to give the cationic ammine species [Pd(2,6-(Cy 2 PCH 2 ) 2 C 6 H 3 )(NH 3 )] + . Complex 4 reacts with diphenyliodonium triflate ([Ph 2 I]OTf) to give aniline complex [Pd(2,6-(Cy 2 PCH 2 ) 2 C 6 H 3 )(NH 2 Ph)]OTf ( 5 ). Reaction of 4 with dialkyl acetylenedicarboxylate (DMAD, DEAD) yields diastereospecific palladium(II) vinyl derivative ( Z )–(Pd(Cy 2 PCH 2 ) 2 C 6 H 3 )(CR = CR(NH 2 )) (R = CO 2 Me ( 6a ), CO 2 Et ( 6b )). Reacting complexes 6a and 6b with p -nitrophenol produces (Pd(Cy 2 PCH 2 ) 2 C 6 H 3 )(OC 6 H 4 – p -NO 2 ) ( 8 ) and cis -CHR = CR(NH 2 ), exclusively. [ABSTRACT FROM AUTHOR]

The cerebrospinal fluid volume affects the block height of spinal anaesthesia. Laminectomy of the lumbar spine may result in increased lumbosacral cerebrospinal fluid volume. This study aimed to test the hypothesis that the lumbosacral cerebrospinal fluid volume of patients with a history of lumbar laminectomy would be larger than that of patients with normal lumbar spine anatomy using magnetic resonance imaging. Lumbosacral spine magnetic resonance images of 147 patients who underwent laminectomy at the L2 vertebrae or below (laminectomy group) and 115 patients without a history of spinal surgery (control group) were retrospectively reviewed. The lumbosacral cerebrospinal fluid volumes between the L1–L2 intervertebral disc level and the end of the dural sac were measured and compared between the two groups. The mean (standard deviation) lumbosacral cerebrospinal fluid volume was 22.3 (7.8) ml and 21.1 (7.4) ml in the laminectomy and control groups, respectively (mean difference 1.2 ml; 95% confidence interval −0.7 to 3.0 ml; P = 0.218). In the prespecified subgroup analysis according to the number of laminectomy levels, patients who underwent more than two levels of laminectomy exhibited slightly larger lumbosacral cerebrospinal fluid volume (n = 17, 30.5 (13.5) ml) compared with those who underwent two (n = 40, 20.7 (5.6) ml; P = 0.014) or one level of laminectomy (n = 90, 21.4 (6.2) ml; P = 0.010) and the control group (21.1 (7.4) ml; P = 0.012). In conclusion, the lumbosacral cerebrospinal fluid volume did not differ between patients who underwent lumbar laminectomy and those without a history of laminectomy. However, patients who underwent laminectomy at more than two levels had a slightly larger volume of lumbosacral cerebrospinal fluid than those who underwent less extensive laminectomy and those without a history of lumbar spine surgery. Further studies are warranted to confirm the subgroup analysis findings and elucidate the clinical implications of such differences in the lumbosacral cerebrospinal fluid volume. [ABSTRACT FROM AUTHOR]

In tauopathies, brain regions with tau accumulation strongly correlate with clinical symptoms, and spreading of misfolded tau along neural network leads to disease progression. However, the underlying mechanisms by which tau proteins enter neurons during pathological propagation remain unclear. To identify membrane receptors responsible for neuronal propagation of tau oligomers, we established a cell-based tau uptake assay and screened complementary DNA expression library. Tau uptake and propagation were analyzed in vitro and in vivo using a microfluidic device and stereotactic injection. The cognitive function of mice was assessed using behavioral tests. From a genome-wide cell-based functional screening, RAGE (receptor for advanced glycation end products) was isolated to stimulate the cellular uptake of tau oligomers. Rage deficiency reduced neuronal uptake of pathological tau prepared from rTg4510 mouse brains or cerebrospinal fluid from patients with Alzheimer's disease and slowed tau propagation between neurons cultured in a 3-chamber microfluidic device. RAGE levels were increased in the brains of rTg4510 mice and tau oligomer-treated neurons. Rage knockout decreased tau transmission in the brains of nontransgenic mice after injection with Alzheimer's disease patient-derived tau and ameliorated memory loss after injection with GFP-P301L-tau-AAV. Treatment of RAGE antagonist FPS-ZM1 blocked transsynaptic tau propagation and inflammatory responses and alleviated cognitive impairment in rTg4510 mice. These results suggest that in neurons and microglia, RAGE binds to pathological tau and facilitates neuronal tau pathology progression and behavioral deficits in tauopathies. [ABSTRACT FROM AUTHOR]

Background: Public health research on sedentary behavior (SB) in youth has heavily relied on accelerometers. However, it has been limited by the lack of consensus on the most accurate accelerometer cut-points as well as by unknown effects caused by accelerometer position (wrist vs. hip) and output (single axis vs. multiple axes). The present study systematically evaluates classification accuracy of different Actigraph cut-points for classifying SB using hip and wrist-worn monitors and establishes new cut-points to enable use of the 3-dimensional vector magnitude data (for both hip and wrist placement). Methods: A total of 125 children ages 7–13 yrs performed 12 randomly selected activities (from a set of 24 different activities) for 5 min each while wearing tri-axial Actigraph accelerometers on both the hip and wrist. The accelerometer data were categorized as either sedentary or non-sedentary minutes using six previously studied cut-points: 100counts-per-minute (CPM), 200CPM, 300CPM, 500CPM, 800CPM and 1100CPM. Classification accuracy was evaluated with Cohen's Kappa (κ) and new cut-points were identified from Receiver Operating Characteristic (ROC). Results: Of the six cut-points, the 100CPM value yielded the highest classification accuracy (κ = 0.81) for hip placement. For wrist placement, all of the cut-points produced low classification accuracy (ranges of κ from 0.44 to 0.67). Optimal sedentary cut-points derived from ROC were 554.3CPM (ROC-AUC of 0.99) for vector magnitude for hip, 1756CPM (ROC-AUC of 0.94) for vertical axis for wrist, and 3958.3CPM (ROC-AUC of 0.93) for vector magnitude for wrist placement. Conclusions: The 100CPM was supported for use with vertical axis for hip placement, but not for wrist placement. The ROC-derived cut-points can be used to classify youth SB with the wrist and with vector magnitude data. [ABSTRACT FROM AUTHOR]

The Apple Watch is one of the most popular wearable devices designed to monitor physical activity (PA). However, it is currently unknown whether the Apple Watch accurately estimates children's free-living PA. Therefore, this study assessed the concurrent validity of the Apple Watch 3 in estimating moderate-to-vigorous physical activity (MVPA) time and active energy expenditure (AEE) for school-aged children under a simulated and a free-living condition. Twenty elementary school students (Girls: 45%, age: 9.7 ± 2.0 years) wore an Apple Watch 3 device on their wrist and performed prescribed free-living activities in a lab setting. A subgroup of participants (N = 5) wore the Apple Watch for seven consecutive days in order to assess the validity in free-living condition. The K5 indirect calorimetry (K5) and GT3X+ were used as the criterion measure under simulated free-living and free-living conditions, respectively. Mean absolute percent errors (MAPE) and Bland-Altman (BA) plots were conducted to assess the validity of the Apple Watch 3 compared to those from the criterion measures. Equivalence testing determined the statistical equivalence between the Apple Watch and K5 for MVPA time and AEE. The Apple Watch provided comparable estimates for MVPA time (mean bias: 0.3 min, p = 0.91, MAPE: 1%) and for AEE (mean bias: 3.8 kcal min, p = 0.75, MAPE: 4%) during the simulated free-living condition. The BA plots indicated no systematic bias for the agreement in MVPA and AEE estimates between the K5 and Apple Watch 3. However, the Apple Watch had a relatively large variability in estimating AEE in children. The Apple Watch was statistically equivalent to the K5 within ±17.7% and ±20.8% for MVPA time and AEE estimates, respectively. Our findings suggest that the Apple Watch 3 has the potential to be used as a PA assessment tool to estimate MVPA in school-aged children. [ABSTRACT FROM AUTHOR]

The parathyroid gland is an endocrine organ that plays a crucial role in regulating calcium levels in blood serum through the secretion of parathyroid hormone (PTH). Hypoparathyroidism is a chronic disease that can occur due to parathyroid defects, but due to the difficulty of creating animal models of this disease or obtaining human normal parathyroid cells, the evaluation of parathyroid functionality for drug development is limited. Although parathyroid-like cells that secrete PTH have recently been reported, their functionality may be overestimated using traditional culture methods that lack in vivo similarities, particularly vascularization. To overcome these limitations, we obtained parathyroid organoids from tonsil-derived mesenchymal stem cells (TMSCs) and fabricated a parathyroid-on-a-chip, capable of simulating PTH secretion based on calcium concentration. This chip exhibited differences in PTH secretion according to calcium concentration and secreted PTH within the range of normal serum levels. In addition, branches of organoids, which are difficult to observe in animal models, were observed in this chip. This could serve as a guideline for successful engraftment in implantation therapies in the future. [ABSTRACT FROM AUTHOR]

Regular participation in aerobic physical activity is associated with a reduced risk of dementia. It is currently unclear whether this association is due to the total volume or intensity of physical activity. This prospective cohort study analyzed 386,486 adults from the UK Biobank who were free of dementia and self-reported >0 minutes of moderate-to-vigorous intensity physical activity (MVPA) at baseline (2007–2010). Participants were categorized as performing 0%, >0%–30%, or >30% of their total MVPA in vigorous activity (VPA). Cox proportional hazards regression models were used to examine the associations between categories of VPA and incident dementia while adjusting for sociodemographic and lifestyle factors including total MVPA. Analyses were performed in 2022. Over an average follow-up of 12.0 (1.7) years, there were 5,177 (1.3%) cases of dementia. Compared to the group reporting 0% VPA, the hazard ratios (95% confidence intervals) of dementia for the groups reporting >0%–30% and >30% VPA were 0.73 (0.68–0.78) and 0.81 (0.75–0.87), respectively, in the fully adjusted model. In a joint analysis, reporting some VPA was associated with a reduced risk of dementia regardless of meeting the aerobic physical activity guidelines (HR=0.78 [0.72–0.85]) or not (HR=0.76 [0.60–0.98]), while meeting the aerobic physical activity guidelines alone without VPA was not associated with incident dementia (HR=0.98 [0.90–1.07]), compared to the group that did not meet the guidelines and reported no VPA. These results suggest that engaging in VPA as part of MVPA is associated with a lower risk of dementia. [ABSTRACT FROM AUTHOR]

A pyrrolyl-iminophosphine (PNNH) which would act as a potential terdentate ligand has been prepared by Schiff base reaction. Complexes [M(PNN)X] (M = Ni; X = Cl (1), Pd; X = Cl (2), Br (3), I (4), M = Pt; X = Cl (5)) were prepared. The title complexes were characterized by various spectroscopic (IR, 1H, 13C, and 31P NMR) and elemental analyses. The molecular structures of 1 , 2 , and 5 have been established by single-crystal X-ray crystallography, demonstrating a distorted square planar geometry comprising two 5-membered metallacyclic rings. Complexes 1 and 2 were found to crystallize in the orthorhombic while complex 5 crystallizes in the monoclinic. Cytotoxicities of the complexes along with PNNH were evaluated against A549 (lung), SK-OV-3 (ovarian), SM-MEL-2 (skin), and HCT15 (colon) human cancer cell lines by sulforhodamine B assay. Notably, the palladium(II) complex (2) shows the highest activity. Apoptosis activity along with the caspase inhibitor Z-VAD (Z-Val-Ala-Asp-fluoromethyl ketone) assay of 2 and 5 against A549 and HCT15 cancer cell lines were investigated to learn a mechanistic pathway for the observed cytotoxicity, practically eliminating an apoptotic cell-death route. Complexes 2 and 5 were studied to DNA cleavage assay and molecular docking simulation. The DNA (pcDNA3.0) cleavage experiment evaluates complex 5 interacting with DNA, more effectively, in comparison to complex 2. Molecular docking simulation of 2 and 5 toward DNA and GRP78 (glucose-regulated protein 78) was performed to predict binding sites of ligand-receptors and a plausible mechanistic aspect of metallodrug-action. Complexes M(PNN)X (M = Ni, Pd, Pt; PNN = PPh 2 (CH 2) 2 N=CHC 4 H 3 N) were prepared and characterized. Cytotoxicities of the complexes were evaluated against human cancer cell lines. Apoptosis activity along with Z-VAD (Z-Val-Ala-Asp-fluoromethyl-ketone), and DNA cleavage assays of 2 and 5 were investigated followed by molecular docking simulation. Unlabelled Image • Novel nickel-triad complexes having pyrrolyl-iminophosphine (PNN) have been prepared. • Single crystal X-ray studies on Ni(II), Pd(II), and Pt(II) complexes with PNN ligand • Cytotoxicity of the title complexes against human cancer cell lines was evaluated. • Apoptosis, pan-caspase inhibitor effect (Z-VAD) and DNA cleavage were investigated. • Molecular docking simulation was performed to determine the probable binding modes. [ABSTRACT FROM AUTHOR]

Background: The evidence for the prospective relationships between specific physical activities (PA), sedentary behaviours (SB) and sleep on subsequent total PA levels is scarce. The purpose of this study was to examine prospective associations of self-reported PA, SB and sleep, and changes in these with subsequent accelerometer-measured PA. Methods: A sub-sample of 91,648 UK Biobank participants reported moderate-to-vigorous PA (MVPA), lifestyle activities, TV viewing, computer use and sleep through screen-based questionnaires at baseline (2006–2010), and provided valid accelerometry data (dominant wrist-worn for 7 days between 2013 and 2015). A further sub-sample of 7709 participants repeated the screen-based questionnaires between 2012 and 2013. Results: In both women (n = 51,545) and men (n = 40,103), positive associations were observed between all self-reported measures of PA at baseline (MVPA, lifestyle/job-related activities, active transporting modes) and accelerometer-measured PA levels at follow-up (median 5.7 years); an exception was 'walking/standing at work' in women. Sedentary time at work, TV viewing and computer use were inversely associated with PA at follow-up. Sleeping either more or less than 7 h/day at baseline was associated with lower PA at follow-up (except for ≤6 h/day in men). In the repeat self-report sub-sample (median 4.3 years), relatively higher physical activity at follow-up was observed in those who maintained or achieved favourable levels of MVPA, walking for pleasure, strenuous sports, other exercises, heavy DIY (in women), heavy physical work, and walking/standing at work (in women), sedentary time at work, getting about methods (in women), commuting methods (in women), TV viewing, computer use or sleep. Conclusions: Initial levels of PA, SB and sleep, and changes in these variables were generally associated with subsequent accelerometer-measured PA in the expected directions, suggesting these specific behaviours all contribute to the total volume of physical activity over time and could thus be targets for intervention. [ABSTRACT FROM AUTHOR]

Background: Little is known about longitudinal associations of exercise with different types of cancer, particularly in Asian populations. The purpose of this research was to estimate the association between the duration of exercise and all-cause and cancer-specific mortality.Method: Data were obtained from the Korean Metabolic Syndrome Mortality Study (KMSMS), a prospective cohort study of 303,428 Korean adults aged 20 years or older at baseline between 1994 and 2004 after exclusion of individuals with missing variables on smoking and exercise. Death certificate-linked data until 31 December 2015 were provided by the Korean National Statistical Office. Cox regression models were constructed to evaluate the associations of exercise with cancer mortality after adjusting for potential confounders such as age, alcohol consumption and smoking status.Results: During the follow-up period of 15.3 years (4,638,863 person-years), a total of 16,884 participants died. Both men and women who exercised showed approximately 30% decreased hazards of mortality, compared to those who did no exercise (hazard ratio (HR) 0.70, 95% confidence interval (CI)=0.68-0.73 for men, HR=0.71, CI : 0.67-0.75). A notable observation of this study is the curvilinear associations between the total duration of exercise per week and cancer mortality, with the lowest risk being observed at the low-to-medium levels of exercise; this trend of associations was found for esophagus, liver, lung, and colorectal cancer mortality in men, and all-cause, all-cancer and lung cancer mortality in women.Conclusions: Individuals who exercised showed considerably lower all-cause and cancer mortality risks compared with those who did no exercise. Policies and clinical trials aimed at promoting minimal or moderate participation in exercise may minimize cancer mortality risk. [ABSTRACT FROM AUTHOR]

Background: UK Biobank is a large prospective cohort study containing accelerometer-based physical activity data with strong validity collected from 100,000 participants approximately 5 years after baseline. In contrast, the main cohort has multiple self-reported physical behaviours from > 500,000 participants with longer follow-up time, offering several epidemiological advantages. However, questionnaire methods typically suffer from greater measurement error, and at present there is no tested method for combining these diverse self-reported data to more comprehensively assess the overall dose of physical activity. This study aimed to use the accelerometry sub-cohort to calibrate the self-reported behavioural variables to produce a harmonised estimate of physical activity energy expenditure, and subsequently examine its reliability, validity, and associations with disease outcomes. Methods: We calibrated 14 self-reported behavioural variables from the UK Biobank main cohort using the wrist accelerometry sub-cohort (n = 93,425), and used published equations to estimate physical activity energy expenditure (PAEESR). For comparison, we estimated physical activity based on the scoring criteria of the International Physical Activity Questionnaire, and by summing variables for occupational and leisure-time physical activity with no calibration. Test-retest reliability was assessed using data from the UK Biobank repeat assessment (n = 18,905) collected a mean of 4.3 years after baseline. Validity was assessed in an independent validation study (n = 98) with estimates based on doubly labelled water (PAEEDLW). In the main UK Biobank cohort (n = 374,352), Cox regression was used to estimate associations between PAEESR and fatal and non-fatal outcomes including all-cause, cardiovascular diseases, respiratory diseases, and cancers. Results: PAEESR explained 27% variance in gold-standard PAEEDLW estimates, with no mean bias. However, error was strongly correlated with PAEEDLW (r = −.98; p < 0.001), and PAEESR had narrower range than the criterion. Test-retest reliability (Λ =.67) and relative validity (Spearman =.52) of PAEESR outperformed two common approaches for processing self-report data with no calibration. Predictive validity was demonstrated by associations with morbidity and mortality, e.g. 14% (95%CI: 11–17%) lower mortality for individuals meeting lower physical activity guidelines. Conclusions: The PAEESR variable has good reliability and validity for ranking individuals, with no mean bias but correlated error at individual-level. PAEESR outperformed uncalibrated estimates and showed stronger inverse associations with disease outcomes. [ABSTRACT FROM AUTHOR]

Highlights • The use of antidepressant medications and the potentially adverse effects of such medications may contribute to the increased cardiovascular disease risk. • Adverse event reporting systems can be used to produce evidence with which to create effective policies for the safe use of drugs. • The occurrence rate of cardiovascular adverse events and clinical symptoms various and depended on the antidepressant used. • Serious adverse events associated with antidepressants may have a significant impact on older patients. Abstract The aim of this study was to evaluate clinical manifestations and the age and sex distribution of cardiovascular adverse events (CVAEs) related to antidepressants. The FDA Adverse Event Reporting System (FAERS) and Korea Adverse Event Reporting System (KAERS) database records on patients prescribed antidepressants were used. The frequency of CVAEs was compared between adults (19–64 years) and an older (age ≥ 65 years) group. In total, 75,608 CVAEs from 43,824 patients and 325 CVAEs from 313 patients in FAERS and KAERS, respectively, were included in the analysis. Among them, 7066 (16.08%) and 103 (32.91%) patients were 65 years of age or older in FAERS and KAERS, respectively. Serious AEs were significantly more common among older patients compared to adults in both the FAERS and KAERS datasets. CVAEs were frequently reported with paroxetine and duloxetine in the FAERS, while amitriptyline and duloxetine were reported in the KAERS. The two most frequent CVAEs were “ventricular arrhythmias and cardiac arrest” and “rate and rhythm disorders” in the FAERS, while “hypotension”, and “oedema”, were found in the KAERS. Several CVAEs were detected by the reporting odds ratios and proportional reporting ratios methods. The serious AEs associated with antidepressants might have a significant impact on older patients. [ABSTRACT FROM AUTHOR]

Background: Car use has been associated with higher risk of coronary heart disease (CHD). However, whether the associations of transport modes with CHD vary by genetic susceptibility to CHD are unknown. This study aims to investigate the associations of genetic susceptibility and modes of transport with incidence of CHD. Methods: We included 339,588 white British participants from UK Biobank with no history of CHD or stroke at baseline or within two years of follow-up (52.3% in work). Genetic susceptibility to CHD was quantified through weighted polygenic risk scores derived from 300 single-nucleotide polymorphisms related to CHD risk. Categories of transport mode included exclusive car use and alternatives to the car (e.g., walking, cycling and public transport), separately for non-commuting (e.g., getting about [n=339,588] excluding commuting for work), commuting (in the sub-set in work [n=177,370] who responded to the commuting question), and overall transport (transport mode for both commuting and non-commuting [n=177,370]). We used Cox regression with age as the underlying timescale to estimate hazard ratios (HR) of CHD (n=13,730; median 13.8-year follow-up) and tested the interaction between genetic susceptibility and travel modes with adjustment for confounders. Results: Compared to those using alternatives to the car, hazards of CHD were higher for exclusive use of cars for overall transport (HR: 1.16, 95% confidence interval (CI): 1.08-1.25), non-commuting (HR: 1.08, 95% CI: 1.04-1.12) and commuting (HR: 1.16, 95% CI: 1.09-1.23), after adjusting for confounders plus genetic susceptibility. HRs of CHD were 1.45 (95% CI: 1.38-1.52) and 2.04 (95% CI: 1.95-2.12) for the second and third tertile of genetic susceptibility to CHD, respectively, compared to the first. There was, in general, no strong evidence of interactions between genetic susceptibility and categories of overall, non-commuting and commuting transport. Estimated 10-year absolute risk of CHD was lower for the alternatives to the car across strata of genetic susceptibility, compared with exclusive use of cars for overall, non-commuting and commuting transport. Conclusion: Exclusive use of cars was associated with a relatively higher risk of CHD across all strata of genetic susceptibility. Using alternatives to the car should be encouraged for prevention of CHD for the general population including individuals at high genetic risk. [ABSTRACT FROM AUTHOR]

Background: Research has clearly demonstrated that excess time spent on sedentary behavior (SB) increases health risks in the population. However, the lack of information on the context of SB in the population prevents a detailed understanding of sedentary lifestyles. The purpose of this study was to characterize the context of SB in a representative sample of adults and to examine differences across various socio-demographic indicators.Methods: A diverse sample of 1442 adults (ages 20-71 year) completed an interviewer-administered 24-h activity recall to provide detailed information about the time, type and location of the previous day's activities. All reported activities were matched with MET scores from the Compendium of Physical Activity but only SB (i.e., METS < 1.5) were extracted for the present analyses.Results: The reported SB were broadly distributed across 5 primary location categories (Work: 27.5%, Community: 24.8%, Home/Indoor: 20.5%, Home/Outdoor: 15.8%, and Transportation: 11.3%). Patterns of SB allocations varied considerably across different socio-demographic indicators indicating the extreme variability in SB in the population.Conclusions: The findings provide unique insights about the context of SB at the population level, and can serve as a guide for developing intervention/policy studies to reduce sedentary time and minimize disparities in SB. [ABSTRACT FROM AUTHOR]

This study assessed children’s physical activity (PA) levels derived from wrist-worn GENEActiv and hip-worn ActiGraph GT3X+ accelerometers and examined the comparability of PA levels between the two devices throughout the segmented week. One hundred and twenty-nine 9–10-year-old children (79 girls) wore a GENEActiv (GAwrist) and ActiGraph GT3X+ (AGhip) accelerometer on the left wrist and right hip, respectively, for 7 days. Mean minutes of light PA (LPA) and moderate-to-vigorous PA (MVPA) per weekday (whole-day, before-school, school and after-school) and weekend day (whole-day, morning and afternoon–evening) segments were calculated, and expressed as percentage of segment time. Repeated measures analysis of variance examined differences in LPA and MVPA between GAwrist and AGhip for each time segment. Bland–Altman plots assessed between-device agreement for LPA and MVPA for whole weekday and whole weekend day segments. Correlations between GAwrist and AGhip were weak for LPA (r = 0.18–0.28), but strong for MVPA (r = 0.80–0.86). LPA and MVPA levels during all weekday and weekend day segments were significantly higher for GAwrist than AGhip (p < 0.001). The largest inter-device percent difference of 26% was observed in LPA during the school day segment. Our data suggest that correction factors are needed to improve raw PA level comparability between GAwrist and AGhip. [ABSTRACT FROM PUBLISHER]

Background: School physical education (PE) is considered as an effective channel for youth to accumulate moderate-to-vigorous physical activity (MVPA) and reduce sedentary time. The purpose of this study was to determine the contributing role of PE in daily MVPA and sedentary time among youth.Methods: The study recruited 67 sixth grade children (29 boys; Mean age = 11.75) from two suburban schools at a U.S. Midwest state, 48 of whom contributed ≥10 hours of physical activity (PA) data per day were included for analysis. An objective monitoring tool (i.e., Sensewear armband monitor) was used to capture the participants' MVPA and sedentary time for 7-14 days. Pearson product-moment correlation analysis (r), multi-level regression analyses, and analysis of variance were conducted for data analysis.Results: MVPA and sedentary time in PE showed significant positive associations with daily MVPA and sedentary time, respectively (r = 0.35, p < 0.01; r = 0.55, p < 0.01). Regression analyses revealed that one minute increase in MVPA and sedentary behavior in PE was associated with 2.04 minutes and 5.30 minutes increases in daily MVPA and sedentary behavior, respectively, after controlling for sex and BMI. The participants demonstrated a significantly higher level of MVPA (p = .05) but similar sedentary time (p = 0.61) on PE days than on non-PE days. Boys had significantly more daily MVPA (p < .01) and less sedentary time (p < .01) than girls; while higher BMI was associated with more sedentary time (p < .01).Conclusions: PE displayed a positive contribution to increasing daily MVPA and decreasing daily sedentary time among youth. Active participation in PE classes increases the chance to be more active and less sedentary beyond PE among youth. [ABSTRACT FROM AUTHOR]

Schools are positioned to play a key role in nurturing students with knowledge and behaviours associated with healthful living. Our study examined the effects of an intervention on energy balance (EB) knowledge. Twelve 6th and 7th grade classrooms (n = 140) were assigned to receive either two standardised lessons on EB or a combined intervention that featured the same EB lessons, integrated with self-monitoring technology. EB knowledge was pre- and post-measured using a standardised written test, while the situational interest was measured at the end of experiment. Repeated measure analysis of variance and multivariate analysis of variance were conducted, to capture the differences in EB knowledge by time and group, and situational interest by group, respectively. Both groups significantly enhanced EB knowledge over time (F1,112 = 11.85; p = .001; η2 = .10), but the combined group demonstrated a greater increase (F1,112 = 5.36; p = .02; η2 = .05). An item-by-item mean comparison of EB knowledge and correct percent scores confirmed the above result (i.e. combined group versus education group: 7% versus 2% EB knowledge increase).The two groups were equally motivated to participate in the experiment, showing similar levels of total interest (education group: M/SD = 4.00/.68; combined group: M/SD = 4.17/.74; p = .18). The research findings and their implications are discussed. [ABSTRACT FROM AUTHOR]

ObjectiveTo review and synthesize existing national and state organizations’ policies related to the nutritional quality of snacks served in after-school programmes (ASP; 15.00–18.00 hours) in the USA.DesignSystematic review of websites and corresponding documentation describing national and state-level ASP organizations’ policies, standards, guidelines and/or recommendations for the nutritional quality of snacks served within the ASP setting.SettingASP can play a critical role in a child's daily dietary intake. State and national organizations have developed policies to assist ASP in selecting nutritionally appropriate snacks, yet no widely accepted standards exist. By reviewing the extent of existing policies, recommendations for uniform policies can be made.SubjectsPolicy documentation.ResultsA total of seventeen organizations representing five unique snack policies comprised of thirteen different food items were identified. The most widely recognized snack policy, which the majority of state and national ASP organizations endorsed and upon which other snack policies were modelled, was the US Department of Agriculture reimbursement programmes. Consistently, policies endorsed serving fruits/vegetables, whole grains and milk/dairy products, and limiting foods high in fats/sugar/energy (calories). Two policies focused predominantly on total energy and macronutrient composition of snacks, a single policy suggested limits on sugar-sweetened beverages, and three endorsed serving water daily. A proposed set of general guidelines for ASP was developed based on uniformity in recommendations across policies.ConclusionsThe proposed set of nutritional guidelines will assist policy makers and ASP providers in selecting and serving nutritionally appropriate snacks that contribute to a child's overall healthful daily dietary intake. [ABSTRACT FROM AUTHOR]

Objective To compare the nonadaptive manual system with the position-adaptive system in subjects with permanent spinal cord stimulator (SCS) implantation over a two-year follow-up period. Design Retrospective study. Setting Tertiary university-based national hospital. Subjects Patients who underwent permanent SCS implantation procedures. Methods Patients were divided into an adaptive group and a nonadaptive group according to the type of implanted SCS device. The primary outcome was the change (%) in pain intensity from baseline between the adaptive and nonadaptive groups at 24 months after SCS implantation. The secondary outcomes were comparisons of detailed clinical variables such as the scores of patient pain and satisfaction during the two-year follow-up after SCS therapy. Further, the number of subjects with SCS removal or revision within two years after SCS implantation was investigated. Results Of 187 patients with permanent SCS implantation, 85 in the nonadaptive group and 64 in the position-adaptive group were finally analyzed. The reduction in pain intensity at 24 months was higher in the adaptive group (−38.6%) than in the nonadaptive group (−30.8%, P  = 0.05). Similarly, patient satisfaction with the SCS treatment at 24 months was superior in the adaptive group than in the nonadaptive group (85.7% vs 67.5% were satisfied in each group, respectively, P  = 0.024). During the two years, 5.3% of patients (N = 10) underwent SCS removal and 7.0% (N = 13) underwent revision procedures. Conclusions There was a trend of a sustained reduction in pain intensity as well as improvement in patient satisfaction at two-year follow-up in the position-adaptive system, suggesting long-term benefit over the nonadaptive manual system during SCS treatment. [ABSTRACT FROM AUTHOR]

Statistical equivalence testing is more appropriate than conventional tests of difference to assess the validity of physical activity (PA) measures. This article presents the underlying principles of equivalence testing and gives three examples from PA and fitness assessment research.The three examples illustrate different uses of equivalence tests. Example 1 uses PA data to evaluate an activity monitor's equivalence to a known criterion. Example 2 illustrates the equivalence of two field-based measures of physical fitness with no known reference method. Example 3 uses regression to evaluate an activity monitor's equivalence across a suite of 23 activities.The examples illustrate the appropriate reporting and interpretation of results from equivalence tests. In the first example, the mean criterion measure is significantly within ±15% of the mean PA monitor. The mean difference is 0.18 METs and the 90% confidence interval of -0.15 to 0.52 is inside the equivalence region of -0.65 to 0.65. In the second example, we chose to define equivalence for these two measures as a ratio of mean values between 0.98 and 1.02. The estimated ratio of mean ...O2 values is 0.99, which is significantly (P = 0.007) inside the equivalence region. In the third example, the PA monitor is not equivalent to the criterion across the suite of activities. The estimated regression intercept and slope are -1.23 and 1.06. Neither confidence interval is within the suggested regression equivalence regions.When the study goal is to show similarity between methods, equivalence testing is more appropriate than traditional statistical tests of differences (e.g., ANOVA and t-tests). [ABSTRACT FROM AUTHOR]

Study Objective: Binaural audio induces sedation and reduces pain and anxiety in surgical patients. This study tested the hypothesis that dexmedetomidine requirement for adequate sedation during spinal anesthesia would be lower in patients listening to music with binaural sound than that in patients listening to plain or no music.Design: A triple-arm, assessor-blind, randomized controlled study.Setting: Operating room.Patients: One hundred and eighty-nine patients undergoing orthopedic surgery under spinal anesthesia.Interventions: Patients were randomly assigned to music with binaural sound, plain music, or no music groups. Dexmedetomidine was infused for sedation during surgery. The loading infusion rate was 6 μg/kg predicted body weight (PBW)/h, followed by continuous infusion at 0.6 μg/kg PBW/hr. Loading was stopped after achieving adequate sedation, defined as the Observer's Assessment of Alertness/Sedation (OAA/S) scale score of 3. Infusion rate was adjusted every 30 min per the OAA/S scale.Measurements: Primary outcomes were the difference in the dexmedetomidine loading dose adjusted for the patient's PBW between (1) the binaural and plain music groups and (2) the binaural and control groups. Secondary outcomes were the total dose and total loading time of dexmedetomidine; Patient State Index; relative powers of the alpha, theta, and delta bands; recovery from sedation; and patient satisfaction score.Main Results: The final analyses included 184 patients. The PBW-adjusted dexmedetomidine loading dose was significantly lower in patients listening to music with binaural sound (1.15 ± 0.30 μg/kg PBW) than that in patients without music (1.33 ± 0.33 μg/kg PBW; mean difference, 0.18 μg/kg PBW; 95% confidence interval [CI], 0.06 to 0.29; P = 0.002). However, the difference was not statistically significant when compared with the plain music group (1.26 ± 0.36 μg/kg PBW; mean difference, 0.11 μg/kg PBW; 95% CI, -0.01 to 0.23; P = 0.070). Dexmedetomidine total dose, recovery from sedation, and patient satisfaction score showed no difference among the three groups.Conclusions: Compared with no music, music with binaural sound reduced the dexmedetomidine loading dose; however, this sedative-sparing effect of binaural sound was not found when compared to plain music. [ABSTRACT FROM AUTHOR]

Acute kidney injury (AKI) after pediatric cardiac surgery is associated with high morbidity and mortality. Modifiable risk factors for postoperative AKI including perioperative anesthesia-related parameters were assessed. The authors conducted a single-center, retrospective cohort study of 220 patients (aged 10 days to 19 years) who underwent congenital cardiac surgery between January and December 2012. The incidence of AKI within 7 days postoperatively was determined using the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Ninety-two patients (41.8%) developed AKI and 18 (8.2%) required renal replacement therapy within the first postoperative week. Among patients who developed AKI, 57 patients (25.9%) were KDIGO stage 1, 27 patients (12.3%) were KDIGO stage 2, and eight patients (3.6%) were KDIGO stage 3. RACHS-1 (Risk-Adjusted classification for Congenital Heart Surgery) category, perioperative transfusion and fluid administration as well as fluid overload were compared between patients with and without AKI. Multivariable logistic regression analyses determined the risk factors for AKI. AKI was associated with longer hospital stay or ICU stay, and frequent sternal wound infections. Younger age (<12 months) [odds ratio (OR), 4.01; 95% confidence interval (CI), 1.77–9.06], longer cardiopulmonary bypass (CPB) time (OR, 2.45; 95% CI, 1.24–4.84), and low preoperative hemoglobin (OR, 2.40; 95% CI, 1.07–5.40) were independent risk factors for AKI. Fluid overload was not a significant predictor for AKI. When a variable of hemoglobin concentration increase (>3 g/dl) from preoperative level on POD1 was entered into the multivariable analysis, it was independently associated with postoperative AKI (OR, 6.51; 95% CI, 2.23–19.03 compared with no increase). This association was significant after adjustment with patient demographics, medication history and RACHS-1 category (hemoglobin increase >3g/dl vs. no increase: adjusted OR, 6.94; 95% CI, 2.33–20.69), regardless of different age groups and cyanotic or non-cyanotic heart disease. Prospective trials are required to evaluate whether correction of preoperative anemia and prevention of hemoconcentration may ameliorate postoperative AKI in patients who underwent congenital cardiac surgery. [ABSTRACT FROM AUTHOR]

Background: The national physical activity guidelines (PAG) in many countries recommend that youth accumulate 60 min or more of moderate-to-vigorous physical activity (MVPA) daily (PAG-MVPA). A daily target of ≥ 11,500 steps/day has been proposed as a step count alternative to this guideline (PAG-Steps). Contemporary activity monitors are capable of estimating both MVPA and steps, but it is not clear how these units compare when used to evaluate compliance with the national PAG. The purpose of this study was to compare prevalence estimates of meeting the PAG-MVPA and PAG-Steps using two commonly used monitors, the ActiGraph (AG) and SenseWear Armband (SWA).Methods: A sample of 69 children (25 girls and 44 boys) aged 9-16 years each wore a wrist-mounted AG and a SWA over a one-week period. Days with ≥10 h of wear time for both monitors were included in the analysis. Estimates of time spent in MVPA were obtained using the Crouter equation for the AG and from proprietary algorithms for the SWA. Step counts for the AG and SWA were directly obtained from the respective software. The prevalence of meeting the PAG-MVPA and PAG-Steps was compared within each monitor, using Cohen's kappa (κ) statistic. Agreement was similarly assessed between monitors using each guideline individually.Results: When assessed with the AG, the prevalence of meeting PAG was substantially higher for the PAG-MVPA (87.2 %) than for the PAG-Steps (54.2 %), with fair classification agreement (κ = 0.30) between the two guidelines. Higher prevalence rates were also observed for the PAG-MVPA (83.6 %) than for the PAG-Steps (33.8 %) when assessed using the SWA, but the prevalence rates and classification agreement (κ = 0.18) were lower than the values from the AG. Classification agreement between AG and SWA was lower for the PAG-MVPA (κ = 0.42) than for the PAG-Steps (κ = 0.55).Conclusions: The results show differential patterns of compliance with the PAG-MVPA and PAG-Steps, as assessed by the AG and SWA. Additional research is needed to directly evaluate and compare findings from public health research based on different guidelines and measurement methods. [ABSTRACT FROM AUTHOR]

The purpose of the study is to examine the associations of youth physical activity and screen time with weight status and cardiorespiratory fitness in children and adolescents, separately, utilizing a nationally representative sample. A total of 1,113 participants (692 children aged 6–11 yrs; 422 adolescents aged 12–15 yrs) from the 2012 NHANES National Youth Fitness Survey. Participants completed physical activity and screen time questionnaires, and their body mass index and cardiorespiratory fitness (adolescents only) were assessed. Adolescents completed additional physical activity questions to estimate daily MET minutes. Children not meeting the screen time guideline had 1.69 times the odds of being overweight/obese compared to those meeting the screen time guideline, after adjusting for physical activity and other control variables. Among adolescent, screen time was significantly associated with being overweight/obese (odds ratio = 1.82, 95% confidence interval: 1.06–3.15), but the association attenuated toward the borderline of being significant after controlling for physical activity. Being physically active was positively associated with cardiorespiratory fitness, independent of screen time among adolescents. In joint association analysis, children who did not meet physical activity nor screen time guidelines had 2.52 times higher odds of being overweight/obese than children who met both guidelines. Adolescents who did not meet the screen time guideline had significantly higher odds ratio of being overweight/obese regardless of meeting the physical activity guideline. Meeting the physical activity guideline was also associated with cardiorespiratory fitness regardless of meeting the screen time guideline in adolescents. Screen time is a stronger factor than physical activity in predicting weight status in both children and adolescents, and only physical activity is strongly associated with cardiorespiratory fitness in adolescents. [ABSTRACT FROM AUTHOR]

Purpose: To assess the relationship between self-reported and objectively measured physical activity (PA) and metabolic syndrome and its risk factors in U.S. adults.Design: A cross-sectional design was used for this study.Setting: The study was set among a nationally representative sample of U.S. adults.Subjects: Adults, ages 20 years and older, from the National Health and Nutrition Examination Survey (NHANES) 2003-2006 (n = 5580) participated in the study.Measures: PA measures included minutes per week of moderate plus vigorous PA estimated by self-report (MVPAsr), total 7-day accelerometry (MVPAa), and accelerometer-based MVPA performed in 10-minute bouts (MVPAb). Risk factors for metabolic syndrome included blood pressure, high-density lipoprotein cholesterol, triglycerides, glucose, and waist circumference.Analysis: Odds ratios (ORs) for having metabolic syndrome were calculated for men and women who met the Physical Activity Guidelines for Americans compared to those who did not.Results: Women who did not meet the PA guidelines had significantly greater odds of having metabolic syndrome according to MVPAsr (OR = 2.20; 95% confidence interval [CI] = 1.65-2.94), MVPAa (OR = 4.40; 95% CI = 2.65-7.31), and MVPAb (OR = 2.91; 95% CI = 1.42-5.96). Men had significantly higher odds of having metabolic syndrome according to MVPAa (OR = 2.57; 95% CI = 1.91-3.45) and MVPAb (OR = 2.83; 95% CI = 1.55-5.17), but not MVPAsr. These ORs remained significant after adjusting for all potential confounders except body mass index, after which only MVPAsr in women and MVPAb in men remained significant.Conclusion: Individuals who do not meet the PA guidelines exhibited greater odds of having metabolic syndrome. This relationship tended to be stronger for objective PA measures than for self-report. [ABSTRACT FROM AUTHOR]

Background: The last few years have seen renewed interest in use-of-time recalls in epidemiological studies, driven by a focus on the 24-h day [including sleep, sitting, and light physical activity (LPA)] rather than just moderate-vigorous physical activity (MVPA). This paper describes four different computerised use-of-time instruments (ACT24, PAR, MARCA and cpar24) and presents population time-use data from a collective sample of 8286 adults from different population studies conducted in Australia/New Zealand, Germany and the United States.Methods: The instruments were developed independently but showed a number of similarities: they were self-administered through the web or used computer-assisted telephone interviews; all captured energy expenditure using variants of the Ainsworth Compendium; each had been validated against criterion measures; and they used a domain structure whereby activities were aggregated under categories such as Personal Care and Work.Results: Estimates of physical activity level (average daily rate of energy expenditure in METs) ranged from 1.53 to 1.78 in the four studies, strikingly similar to population estimates derived from doubly labelled water. There was broad agreement in the amount of time spent in sleep (7.2-8.6 h), MVPA (1.6-3.1 h), personal care (1.6-2.4 h), and transportation (1.1-1.8 h). There were consistent sex differences, with women spending 28-81% more time on chores, 8-40% more time in LPA, and 3-39% less time in MVPA than men.Conclusions: Although there were many similarities between instruments, differences in operationalizing definitions of sedentary behaviour and LPA resulted in substantive differences in the amounts of time reported in sedentary and physically active behaviours. Future research should focus on deriving a core set of basic activities and associated energy expenditure estimates, an agreed classificatory hierarchy for the major behavioural and activity domains, and systems to capture relevant social and environmental contexts. [ABSTRACT FROM AUTHOR]