Meeting, Moving, Mastering - A Text Analysis of the Aesthetic Attractions of \u27Wild Swimming\u27

Why are people fascinated by swimming in nature? This article addresses the aesthetic experiences of wild swimming as expressed by five wild swimming authors in their books. Drawing from aesthetic philosophy, we analyze the ways in which the appeal of wild swimming is described on three levels: the allure of water in the environment, the sensory encounter between water and the body, and the experience of moving in water. Furthermore, with reference to Seel’s concept of nature aesthetics (1996), the experience of wild swimming is analyzed in terms of contemplation, correspondence, and imagination. We can conclude that the special intensity of the sensory experience of moving in water allows a closer connectedness to the surrounding natural world than land-based activities or swimming in artificial outdoor pools. This leads to a stronger ethical awareness, both regarding protection of natural water as well as the necessity of developing ‘water competency’ amongst humans

Cabbage and fermented vegetables : From death rate heterogeneity in countries to candidates for mitigation strategies of severe COVID-19

Large differences in COVID-19 death rates exist between countries and between regions of the same country. Some very low death rate countries such as Eastern Asia, Central Europe, or the Balkans have a common feature of eating large quantities of fermented foods. Although biases exist when examining ecological studies, fermented vegetables or cabbage have been associated with low death rates in European countries. SARS-CoV-2 binds to its receptor, the angiotensin-converting enzyme 2 (ACE2). As a result of SARS-CoV-2 binding, ACE2 downregulation enhances the angiotensin II receptor type 1 (AT(1)R) axis associated with oxidative stress. This leads to insulin resistance as well as lung and endothelial damage, two severe outcomes of COVID-19. The nuclear factor (erythroid-derived 2)-like 2 (Nrf2) is the most potent antioxidant in humans and can block in particular the AT(1)R axis. Cabbage contains precursors of sulforaphane, the most active natural activator of Nrf2. Fermented vegetables contain many lactobacilli, which are also potent Nrf2 activators. Three examples are: kimchi in Korea, westernized foods, and the slum paradox. It is proposed that fermented cabbage is a proof-of-concept of dietary manipulations that may enhance Nrf2-associated antioxidant effects, helpful in mitigating COVID-19 severity.Peer reviewe

Nrf2-interacting nutrients and COVID-19 : time for research to develop adaptation strategies

There are large between- and within-country variations in COVID-19 death rates. Some very low death rate settings such as Eastern Asia, Central Europe, the Balkans and Africa have a common feature of eating large quantities of fermented foods whose intake is associated with the activation of the Nrf2 (Nuclear factor (erythroid-derived 2)-like 2) anti-oxidant transcription factor. There are many Nrf2-interacting nutrients (berberine, curcumin, epigallocatechin gallate, genistein, quercetin, resveratrol, sulforaphane) that all act similarly to reduce insulin resistance, endothelial damage, lung injury and cytokine storm. They also act on the same mechanisms (mTOR: Mammalian target of rapamycin, PPAR gamma:Peroxisome proliferator-activated receptor, NF kappa B: Nuclear factor kappa B, ERK: Extracellular signal-regulated kinases and eIF2 alpha:Elongation initiation factor 2 alpha). They may as a result be important in mitigating the severity of COVID-19, acting through the endoplasmic reticulum stress or ACE-Angiotensin-II-AT(1)R axis (AT(1)R) pathway. Many Nrf2-interacting nutrients are also interacting with TRPA1 and/or TRPV1. Interestingly, geographical areas with very low COVID-19 mortality are those with the lowest prevalence of obesity (Sub-Saharan Africa and Asia). It is tempting to propose that Nrf2-interacting foods and nutrients can re-balance insulin resistance and have a significant effect on COVID-19 severity. It is therefore possible that the intake of these foods may restore an optimal natural balance for the Nrf2 pathway and may be of interest in the mitigation of COVID-19 severity

Atrasentan and renal events in patients with type 2 diabetes and chronic kidney disease (SONAR): a double-blind, randomised, placebo-controlled trial

Background: Short-term treatment for people with type 2 diabetes using a low dose of the selective endothelin A receptor antagonist atrasentan reduces albuminuria without causing significant sodium retention. We report the long-term effects of treatment with atrasentan on major renal outcomes. Methods: We did this double-blind, randomised, placebo-controlled trial at 689 sites in 41 countries. We enrolled adults aged 18–85 years with type 2 diabetes, estimated glomerular filtration rate (eGFR)25–75 mL/min per 1·73 m 2 of body surface area, and a urine albumin-to-creatinine ratio (UACR)of 300–5000 mg/g who had received maximum labelled or tolerated renin–angiotensin system inhibition for at least 4 weeks. Participants were given atrasentan 0·75 mg orally daily during an enrichment period before random group assignment. Those with a UACR decrease of at least 30% with no substantial fluid retention during the enrichment period (responders)were included in the double-blind treatment period. Responders were randomly assigned to receive either atrasentan 0·75 mg orally daily or placebo. All patients and investigators were masked to treatment assignment. The primary endpoint was a composite of doubling of serum creatinine (sustained for ≥30 days)or end-stage kidney disease (eGFR <15 mL/min per 1·73 m 2 sustained for ≥90 days, chronic dialysis for ≥90 days, kidney transplantation, or death from kidney failure)in the intention-to-treat population of all responders. Safety was assessed in all patients who received at least one dose of their assigned study treatment. The study is registered with ClinicalTrials.gov, number NCT01858532. Findings: Between May 17, 2013, and July 13, 2017, 11 087 patients were screened; 5117 entered the enrichment period, and 4711 completed the enrichment period. Of these, 2648 patients were responders and were randomly assigned to the atrasentan group (n=1325)or placebo group (n=1323). Median follow-up was 2·2 years (IQR 1·4–2·9). 79 (6·0%)of 1325 patients in the atrasentan group and 105 (7·9%)of 1323 in the placebo group had a primary composite renal endpoint event (hazard ratio [HR]0·65 [95% CI 0·49–0·88]; p=0·0047). Fluid retention and anaemia adverse events, which have been previously attributed to endothelin receptor antagonists, were more frequent in the atrasentan group than in the placebo group. Hospital admission for heart failure occurred in 47 (3·5%)of 1325 patients in the atrasentan group and 34 (2·6%)of 1323 patients in the placebo group (HR 1·33 [95% CI 0·85–2·07]; p=0·208). 58 (4·4%)patients in the atrasentan group and 52 (3·9%)in the placebo group died (HR 1·09 [95% CI 0·75–1·59]; p=0·65). Interpretation: Atrasentan reduced the risk of renal events in patients with diabetes and chronic kidney disease who were selected to optimise efficacy and safety. These data support a potential role for selective endothelin receptor antagonists in protecting renal function in patients with type 2 diabetes at high risk of developing end-stage kidney disease. Funding: AbbVie

Zen and the art of swimming

Zen in umetnost plavanja: estetska izkušnja kot nova perspektiva za tehniko vadbe Zadnja leta narašča zanimanje za koncepte alternativnih gibanj. Zavedanje je dobro znano v športni psihologiji in mnoge športe propagirajo kot "zen šport". Tudi uporaba fraze "zen in umetnost" je že postala vsakdanja. Ljudje, ki se učijo in ki poučujejo tehnike plavanja, se zaradi posebnih pogojev, ki jih povzroča voda, soočajo z edinstvenimi izzivi. Pristop, ki temelji na dojemanju plavanja kot zen športa ali kot umetnosti v smislu čutne estetske izkušnje in estetskega procesa učenja, lahko nudi nove priložnosti za učenje in poučevanje. Filozofske koncepte Gadamerja, Deweyja in Johnsona v kombinaciji s pristopi teorij utelešenja in teorij estetskega učnega procesa povezujemo s temeljnimi elementi Zena in dopolnjujemo ter pojasnjujemo s praktičnimi primeri.The interest in alternative movement concepts has been on the increase in recent years. Mindfulness is well known in sports psychology, and many sports have been promoted as "Zen sports". The use of the phrase "Zen and the Art of " has also become commonplace. People learning and teaching swimming techniques face unique challenges due to the special conditions that water provides. The approach based on looking at swimming as a Zen sport, or as an art in the sense of being a sensual aesthetic experience, and an aesthetic learning process, can provide new teaching and learning opportunities. Gadamer\u27s, Dewey\u27s, and Johnson\u27s philosophical concepts combined with approaches of embodiment theories and theories of aesthetic learning processes (Storch, Stelter, Gallagher) have been brought together with the basic elements from Zen and supplemented and exemplified with practical examples

Zen and the Art of Swimming – Aesthetical Experience as a New Perspective for Training Technique

The interest in alternative movement concepts has been on the increase in recent years. Mindfulness is well known in sports psychology, and many sports have been promoted as ‘Zen sports’. The use of the phrase ‘Zen and the Art of ...’ has also become commonplace. People learning and teaching swimming techniques face unique challenges due to the special conditions that water provides. The approach based on looking at swimming as a Zen sport, or as an art in the sense of being a sensual aesthetic experience, and an aesthetic learning process, can provide new teaching and learning opportunities. Gadamer’s, Dewey’s, and Johnson’s philosophical concepts combined with approaches of embodiment theories and theories of aesthetic learning processes (Storch, Stelter, Gallagher) have been brought together with the basic elements from Zen and supplemented and exemplified with practical examples

The Monitoring Efficacy of Neurogenic Bowel Dysfunction Treatment on Response (MENTOR) in a Non-Hospital Setting

Background: Most patients with a spinal cord injury (SCI) suffer from neurogenic bowel dysfunction (NBD). In spite of well-established treatment algorithms, NBD is often insufficiently managed. The Monitoring Efficacy of Neurogenic bowel dysfunction Treatment On Response (MENTOR) has been validated in a hospital setting as a tool to support clinical decision making in individual patients. The objective of the present study was to describe clinical decisions recommended by the MENTOR (either &ldquo;monitor&rdquo;, &ldquo;discuss&rdquo; or &ldquo;act&rdquo;) and the use of the tool to monitor NBD in a non-hospital setting. Methods: A questionnaire describing background data, the MENTOR, ability to work and participation in various social activities was sent by mail to all members of The Danish Paraplegic Association. Results: Among 1316 members, 716 (54%) responded, 429 men (61%) and 278 women (39%), aged 18 to 92 (median 61) years. Based on MENTOR, the recommended clinical decision is to monitor treatment of NBD in 281 (44%), discuss change in treatment in 175 (27%) and act/change treatment in 181 (28%). A recommendation to discuss or change treatment was associated with increasing age of the respondent (p = 0.016) and with impaired ability to work or participate in social activities (p &lt; 0.0001). Conclusion: A surprisingly high proportion of persons with SCI have an unmet need for improved bowel care. The MENTOR holds promise as a tool for evaluation of treatment of NBD in a non-hospital setting

Alternative lengthening of telomeres is the major telomere maintenance mechanism in astrocytoma with isocitrate dehydrogenase 1 mutation.

PURPOSE: Isocitrate dehydrogenase 1 (IDH1) mutations are associated with improved survival in gliomas. Depending on the IDH1 status, TERT promoter mutations affect prognosis. IDH1 mutations are associated with alpha-thalassemia/mental retardation syndrome X-linked (ATRX) mutations and alternative lengthening of telomeres (ALT), suggesting an interaction between IDH1 and telomeres. However, little is known how IDH1 mutations affect telomere maintenance. METHODS: We analyzed cell-specific telomere length (CS-TL) on a single cell level in 46 astrocytoma samples (WHO II-IV) by modified immune-quantitative fluorescence in situ hybridization, using endothelial cells as internal reference. In the same samples, we determined IDH1/TERT promoter mutation status and ATRX expression. The interaction of IDH1(R132H) mutation and CS-TL was studied in vitro using an IDH1(R132H) doxycycline-inducible glioma cell line system. RESULTS: Virtually all ALT(positive) astrocytomas had normal TERT promoter and lacked ATRX expression. Further, all ALT(positive) samples had IDH1(R132H) mutations, resulting in a significantly longer CS-TL of IDH1(R132H) gliomas, when compared to their wildtype counterparts. Conversely, TERT promotor mutations were associated with IDH(wildtype), ATRX expression, lack of ALT and short CS-TL. ALT, TERT promoter mutations, and CS-TL remained without prognostic significance, when correcting for IDH1 status. In vitro, overexpression of IDH(R132H) in the glioma cell line LN319 resulted in downregulation of ATRX and rapid TERT-independent telomere lengthening consistent with ALT. CONCLUSION: ALT is the major telomere maintenance mechanism in IDH(R132H) mutated astrocytomas, while TERT promoter mutations were associated with IDH(wildtype) glioma. IDH1(R132H) downregulates ATRX expression in vitro resulting in ALT, which may contribute to the strong association of IDH1(R132H) mutations, ATRX loss, and ALT