Biological rhythms, chronodisruption and chrono-enhancement: The role of physical activity as synchronizer in correcting steroids circadian rhythm in metabolic dysfunctions and cancer

This is an Accepted Manuscript of an article published by Taylor & Francis in Chronobiology International on 28 June 2018, available online: http://www.tandfonline.com/10.1080/07420528.2018.1475395.Rhythms can be observed at all levels of the biologic integration in humans. The observation that a biological or physiological variable shows a circadian rhythm can be explained by several multifactorial systems including external (exogenous), internal (endogenous) and psychobiological (lifestyle) mechanisms. Our body clock can be synchronized with the environment by external factors, called “synchronizers”, i.e. the light–dark cycle, but it is also negatively influenced by some pathological conditions or factors, called “chronodisruptors,” i.e. aging or low physical activity (PA). The desynchronization of a 24-h rhythm in a chronic manner has been recently defined “chronodisruption” or “circadian disruption.” A very large number of hormonal variables, such as adrenal and gonadal stress steroids, are governed by circadian rhythmicity. Such hormones, in normal conditions, show a peak in the first part of the day, while their typical diurnal fluctuations are totally out of sync in subjects affected by cancer or metabolic diseases, such as obesity, diabetes and metabolic syndrome. In general, a flatter slope with altered peaks in cortisol and testosterone circadian rhythms has been observed in pathological individuals. PA, specifically chronic exercise, seems to play a key role as synchronizer for the whole circadian system in such pathologies even if specific data on steroids circadian pattern are still sparse and contradictory. Recently, it has been proposed that low-intensity chronic PA could be an effective intervention to decrease morning cortisol levels in pathological subjects. The standardization of all confounding factors is needed to reach more clear evidence-based results

Regional anticoagulation with heparin of an extracorporeal CO 2 removal circuit: A case report

Background: Extracorporeal carbon dioxide removal is an increasingly used respiratory support technique. As is true of all extracorporeal techniques, extracorporeal carbon dioxide removal needs proper anticoagulation. We report a case of a patient at risk of bleeding complications who was treated with extracorporeal carbon dioxide removal and anticoagulated with a regional technique. Case presentation: A 56-year-old Caucasian man with a history of chronic obstructive pulmonary disease exacerbation required extracorporeal carbon dioxide removal for severe hypercapnia and acidosis despite mechanical ventilation. The extracorporeal circuit was anticoagulated using a regional heparin technique to limit the patient's risk of bleeding due to a low platelet count. The patient underwent 96 h of effective extracorporeal carbon dioxide removal without any adverse events. He was successfully weaned from extracorporeal carbon dioxide removal. During the treatment, no bleeding complications or unexpected circuit clotting was observed. Conclusions: The use of regional heparin anticoagulation technique seems to be feasible and safe during extracorporeal carbon dioxide removal

The impact of a 14-day altitude training camp on olympic-level open-water swimmers' sleep

Despite the common belief that sleep quality at altitude is poor, the scientific evidence to support this notion is still modest. Therefore, the purpose of the present study was to evaluate possible changes of actigraphy-based and subjective sleep parameters in a group of elite open-water swimmers during a 14-day altitude training camp (ATC) at 1500 m. The study subjects were five Olympic-level open-water swimmers (mean age: 25.0 ± 3.2 years; 3 females and 2 males). All subjects wore a wrist activity monitor and filled a sleep diary for 18 consecutive nights, 4 nights before and 14 nights during ATC. The data were then analyzed at four different time points: before ATC (PRE), the first two days of ATC (T1), and after one (T2) and two weeks of ATC (T3). Training load, assessed as the covered distance (km), session rating of perceived exertion (sRPE), and heart rate (HR), was monitored during the week before and the first and second week of ATC. No significant differences in objective and subjective scores of sleep quality were detected, whereas the sleep onset time (p = 0.018; η2p = 0.83, large) and sleep offset time (p < 0.001; η2p = 0.95, large) significantly differed among PRE, T1, T2, and T3: elite athletes started to sleep and woke up ≃ 1 h earlier the first two days of ATC compared to PRE (sleep onset time: p = 0.049; sleep offset time: p = 0.016). Further, an increase in the training volume during the two weeks of the ATC was observed, with the most time spent in a low-intensity regime and an increase in time spent in a high-intensity regime compared to PRE. Sleep quality was not negatively influenced by a 14-day altitude training camp at 1500 m in a group of Olympic-level elite swimmers despite an increase in perceived exertion during training sessions. Nonetheless, early sleep onset and sleep offset times were observed for the first two nights of ATC: elite athletes started to sleep and woke up ≃ 1 h earlier compared to the baseline nights

Anthropometric indices of adiposity and fasting glucose metabolism in breast cancer survivors: effects of aerobic physical activity

Adiposity and hypersinsulinemia are factors involved in cancer mortality including BC (1). Physical activity (PA) has the potential to counterbalance these risk factors. In fact, PA has been shown to produce beneficial effects on adiposity and glucose metabolism (2). We thus designed a randomized controlled trial to test the effect of an aerobic PA program on anthropometric indices of adiposity and fasting glucose metabolism in BC women included in a dietary intervention trial for prevention of BC recurrences. 42 BC women, aged 35-70 years, were randomized into an intervention (IG=19) and control group (CG=23). The IG had to participate in a 3-month active PA program that included two sessions of one-hour brisk walking per week. At baseline and after 3-month, all women were requested to undergo an anthropometric visit and to collect a blood sample for determination of fasting insulin and glucose levels. At the end of the 3-month PA a significant reduction in waist circumference (p<0.05) and percentage fat mass (p<0.01) were observed in IG, but not in CG. In addition, only IG increased significantly their Metabolic Equivalent of Task (METs) (p<0.05). Although fasting glucose and insulin levels don’t show any significant change in either group, it is nevertheless encouraging that the two groups displayed an opposite trend as far as the changes in fasting insulin were concerned: fasting insulin shows a mean reduction (-0.9 U//ml) in the IG group and a mean increment in the CG (+0.7 U/ml). The results suggest that a standardized PA program in BC survivors reduces anthropometric indices of adiposity and may prove useful in preventing the development of hyperinsulinemic levels

Reliability of activity monitors for physical activity assessment in patients with musculoskeletal disorders: A systematic review

BACKGROUND: Activity monitors have been introduced in the last years to objectively measure physical activity to help physicians in the management of musculoskeletal patients. OBJECTIVE: This systematic review aimed at describing the assessment of physical activity by commercially available portable activity monitors in patients with musculoskeletal disorders. METHODS: PubMed, Embase, PEDro, Web of Science, Scopus and CENTRAL databases were systematically searched from inception to June 11th, 2020. We considered as eligible observational studies with: musculoskeletal patients; physical activity measured by wearable sensors based on inertial measurement units; comparisons performed with other tools; outcomes consisting of number of steps/day, activity/inactivity time, or activity counts/day. RESULTS: Out of 595 records, after removing duplicates, title/abstract and full text screening, 10 articles were included. We noticed a wide heterogeneity in the wearable devices, that resulted to be 10 different types. Patients included suffered from rheumatoid arthritis, osteoarthritis, juvenile idiopathic arthritis, polymyalgia rheumatica, and fibromyalgia. Only 3 studies compared portable activity trackers with objective measurement tools. CONCLUSIONS: Taken together, this systematic review showed that activity monitors might be considered as useful to assess physical activity in patients with musculoskeletal disorders, albeit, to date, the high device heterogeneity and the different algorithms still prevent their standardization

Anthropometric and performance differences among playing positions between Italian and American high school football players

Height, body weight and body composition are different among American football players and this is due to the different movement demands for each playing position (1). The results of the National Football League (NFL) Combines are different for playing position and they are used by coaches and scouts to assess players’ physical abilities as a determinant of their success in the professional level (2). The purpose of this study was to examine anthropometric and performance differences among young football players of a top Italian team (Rhinos Milan) and to compare these values with the American high school football players. Participants (N=62) were categorized by position in 3 groups based on playing position: Skill players (SP) included wide receivers, cornerbacks, safeties, and running backs; Big skill players (BSP) consisted of fullbacks, linebackers, tight ends, and defensive ends; Lineman (LM) included centers, offensive guards, offensive and defensive tackles. Body weight and percentage of body fat were determined using the TANITA Body Composition Monitor BC-418 and we obtained performance results of the following Nike SPARQ Combine drills: 40-yard dash, vertical jump, 20-yard shuttle and the kneeling power ball toss (KPBT). The one-way ANOVA followed by the Tukey-Kramer post-hoc test showed significant differences for all the variables among the 3 playing categories: LM had higher anthropometric and body composition values than SP (

Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy

IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis. OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery. EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections. MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P < .001), and stenotic lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03). CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients

Search for eccentric black hole coalescences during the third observing run of LIGO and Virgo

Despite the growing number of confident binary black hole coalescences observed through gravitational waves so far, the astrophysical origin of these binaries remains uncertain. Orbital eccentricity is one of the clearest tracers of binary formation channels. Identifying binary eccentricity, however, remains challenging due to the limited availability of gravitational waveforms that include effects of eccentricity. Here, we present observational results for a waveform-independent search sensitive to eccentric black hole coalescences, covering the third observing run (O3) of the LIGO and Virgo detectors. We identified no new high-significance candidates beyond those that were already identified with searches focusing on quasi-circular binaries. We determine the sensitivity of our search to high-mass (total mass M>70 M⊙) binaries covering eccentricities up to 0.3 at 15 Hz orbital frequency, and use this to compare model predictions to search results. Assuming all detections are indeed quasi-circular, for our fiducial population model, we place an upper limit for the merger rate density of high-mass binaries with eccentricities 0<e≤0.3 at 0.33 Gpc−3 yr−1 at 90\% confidence level

Ultralight vector dark matter search using data from the KAGRA O3GK run

Among the various candidates for dark matter (DM), ultralight vector DM can be probed by laser interferometric gravitational wave detectors through the measurement of oscillating length changes in the arm cavities. In this context, KAGRA has a unique feature due to differing compositions of its mirrors, enhancing the signal of vector DM in the length change in the auxiliary channels. Here we present the result of a search for U(1)B−L gauge boson DM using the KAGRA data from auxiliary length channels during the first joint observation run together with GEO600. By applying our search pipeline, which takes into account the stochastic nature of ultralight DM, upper bounds on the coupling strength between the U(1)B−L gauge boson and ordinary matter are obtained for a range of DM masses. While our constraints are less stringent than those derived from previous experiments, this study demonstrates the applicability of our method to the lower-mass vector DM search, which is made difficult in this measurement by the short observation time compared to the auto-correlation time scale of DM