Physical, Cardiovascular, & Metabolic Effects of Non-Exercise Weighted Vest Training

Introduction: The high prevalence of obesity and sedentary lifestyle contribute to the growing burden of health care costs, incidence of disease, and mortality, making a lifestyle that includes regular physical activity increasingly important. Low intensity resistance training has been studied as a possible intervention to increase physical activity in inactive individuals. Purpose: To determine the effects of a weighted vest treatment (WV) on steady state VO2, O2 deficit, VO2max, body mass index (BMI), and resting blood pressure (RBP). Methods: Fourteen college age women participated in a 4 week trial and completed both pre and posttest evaluations. These evaluations included a submaximal exercise bout, a maximal graded exercise test, determination of BMI, and measurement of RBP. Seven participants wore a weighted vest, fitted with 10% of their body weight, during normal daily activities for a minimum of 10 hours a day, 5 days each week. The remaining 7 participants served as a control group. ANCOVAs, with pretest measures serving as the covariates, were conducted to determine the effect of WV on posttest responses. Results: Mean (sd) pre-test O2 deficit values were 0.64 (0.18) and 0.68 (0.18) for the control and WV groups, respectively. Mean (sd) post-test O2 deficit values were 0.62 (0.15) and 0.38 (0.17) for the control and WV groups, respectively. Results of the ANCOVA revealed a significant effect of WV on O2 deficit with O2 deficit values being lower following WV (F(1,11) = 7.30, p = 0.02). Further, WV accounted for about 40% of the change observed in posttest O2 deficit values (ηp2 = 0.40). However, no significant effect of WV was seen on steady state VO2, VO2 max, BMI, or RBP. Conclusion: WV resulted in lower O2 deficit values suggesting that it could elicit training effects related to improved aerobic function. Possible explanations for the lack of effects on other variables could be related to the limitations imposed by the relatively small sample size and trial length. Future studies designed with larger sample sizes and longer trial periods might prove more effective in evaluating the effect of WV on eliciting health related benefits

Perceptual Sensitivity and Response to Strong Stimuli Are Related

To shed new light on the long-standing debate about the (in)dependence of sensitivity to weak stimuli and overreactivity to strong stimuli, we examined the relation between these tendencies within the neurobehavioral framework of the Predictive and Reactive Control Systems (PARCS) theory (Tops et al., 2010, 2014). Whereas previous studies only considered overreactivity in terms of the individual tendency to experience unpleasant affect (punishment reactivity) resulting from strong sensory stimulation, we also took the individual tendency to experience pleasant affect (reward reactivity) resulting from strong sensory stimulation into account. According to PARCS theory, these temperamental tendencies overlap in terms of high reactivity toward stimulation, but oppose each other in terms of the response orientation (approach or avoid). PARCS theory predicts that both types of reactivity to strong stimuli relate to sensitivity to weak stimuli, but that these relationships are suppressed due to the opposing relationship between reward and punishment reactivity. We measured punishment and reward reactivity to strong stimuli and sensitivity to weak stimuli using scales from the Adult Temperament Questionnaire (Evans and Rothbart, 2007). Sensitivity was also measured more objectively using the masked auditory threshold. We found that sensitivity to weak stimuli (both self-reported and objectively assessed) was positively associated with self-reported punishment and reward reactivity to strong stimuli, but only when these reactivity measures were controlled for each other, implicating a mutual suppression effect. These results are in line with PARCS theory and suggest that sensitivity to weak stimuli and overreactivity are dependent, but this dependency is likely to be obscured if punishment and reward reactivity are not both taken into account

Association between cardiovascular disease and a history of cancer in patients with chest pain on the fast track outpatient clinic

Background: The purpose of this study is to investigate the prevalence of a history of malignancy in patients with chest pain who were referred for computed tomography angiography as well as the long-term survival and cardiovascular outcomes, including coronary artery disease (CAD) and coronary artery calcium (CAC) percentiles of cancer survivors. These data are relevant since it is unknown how cancer survivors, who underwent cardio-toxic therapies, should be monitored. Methods: We analysed all patients with chest pain, who came to the outpatient clinic and underwent computed tomography angiography. The primary study endpoint was long-term survival. The secondary endpoints included CAD on computed tomography angiogram (CTA), CAC percentiles, suspected and confirmed malignancy on CTA, and other accidental findings on CTA. Results: Of all 1,892 patients included in the analyses, 133 (7%) had a history of malignancy and 1,759 (93%) did not. Mortality rates were higher for the cancer survivors (6.5% vs 20.9% after ten years, p < 0.001). The multivariable Cox regression model also showed higher mortality for cancer survivors after ten years (adjusted hazard ratio 2.48 [95% confidence interval: 1.58–3.90]). CAD did not differ between both groups. CAC percentiles were higher in cancer survivors (p = 0.037). Cancer survivors had more suspected malignancies (3.8% vs 0.5%; p = 0.001) and also more confirmed malignancies on CTA (3.0% vs 0.1%; p < 0.001). Conclusions: Cancer survivors have higher mortality rates, no difference in CAD on CTA, higher CAC percentiles and more often malignancy on CTA compared with patients without a cancer history

Mindfulness-Based Program Plus Amygdala and Insula Retraining (MAIR) for the Treatment of Women with Fibromyalgia : a Pilot Randomized Controlled Trial

The lack of highly effective treatments for fibromyalgia (FM) represents a great challenge for public health. The objective of this parallel, pilot randomized controlled trial (RCT) was two-fold: (1) to analyze the clinical effects of mindfulness plus amygdala and insula retraining (MAIR) compared to a structurally equivalent active control group of relaxation therapy (RT) in the treatment of FM; and (2) to evaluate its impact on immune-inflammatory markers and brain-derived neurotrophic factor (BDNF)in serum. A total of 41 FM patients were randomized into two study arms: MAIR (intervention group)and RT (active control group), both as add-ons of treatment as usual. MAIR demonstrated significantly greater reductions in functional impairment, anxiety, and depression, as well as higher improvements in mindfulness, and self-compassion at post-treatment and follow-up, with moderate to large effectsizes. Significant decreases in pain catastrophizing and psychological inflexibility and improvementsin clinical severity and health-related quality of life were found at follow-up, but not at post-treatment,showing large effect sizes. The number needed to treat was three based on the criteria of ≥50% Fibromyalgia Impact Questionnaire (FIQ) reduction post-treatment. Compared to RT, the MAIRshowed significant decreases in BDNF. No effect of MAIR was observed in immune-inflammatorybiomarkers (i.e., TNF-α, IL-6, IL-10, and hs-CRP). In conclusion, these results suggest that MAIR, as an adjuvant of treatment-as-usual (TAU), appears to be effective for the management of FM symptomsand for reducing BDNF levels in serum

EASIX and severe endothelial complications after CD19-directed CAR-T Cell therapy-a cohort study

BACKGROUND: Endothelial dysfunction is associated with two main complications of chimeric antigen receptor T (CAR-T) cell therapy, cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). This study evaluates the Endothelial Activation and Stress Index (EASIX) as a prognostic marker for high-grade CRS and ICANS in patients treated with CD19-directed CAR-T cells. METHODS: In this retrospective study, a training cohort of 93 patients from the ZUMA-1 trial and a validation cohort of 121 patients from two independent centers (University Hospital Heidelberg, Charité University Medicine Berlin) were investigated. The primary objective was to assess the predictive capacity of EASIX measured immediately before the start of lymphodepletion (EASIX-pre) for the occurrence of grade =3 CRS and/or ICANS. To explore a possible endothelial link, serum levels of endothelial stress markers (angiopoietin-2, suppressor of tumorigenicity-2, soluble thrombomodulin, and interleukin-8) were determined before lymphodepletion and on day 7 after CART infusion in the validation cohort (n = 47). RESULTS: The prognostic effect of EASIX-pre on grade =3 CRS and/or ICANS was significant in the training cohort [OR 2-fold increase 1.72 (1.26-2.46)] and validated in the independent cohort. An EASIX-pre cutoff >4.67 derived from the training cohort associated with a 4.3-fold increased odds ratio of severe CRS/ICANS in the independent cohort. Serum endothelial distress markers measured on day+7 correlated with EASIX-pre and associated with severe complications. CONCLUSIONS: EASIX-pre is a powerful predictor of severe CRS/ICANS after CD19-directed CART therapy and might be used as a basis for risk-adapted prevention strategies