Effects of aquatic exercises for women with rheumatoid arthritis: a 12-week intervention in a quasi-experimental study with pain as a mediator of depression

Background: Rheumatoid arthritis (RA) is characterized by low physical fitness, pain, and depression. The present study aimed to examine the effects of a supervised aquatic exercise program on physical fitness, depression, and pain in women with RA and determine whether decreases in pain mediate depression. Methods: Forty-three women with RA, divided into an experimental group (EG; n = 21) and a control group (CG; n = 23), participated in a 12-week exercise program. Treatment effects were calculated via standardized difference or effect size (ES) using ANCOVA adjusted for baseline values (ES, 95% confidence interval (CI)). A simple panel of mediation was executed to determine whether changes in pain mediated improvements in depression after controlling for confounding variables, such as age, physical activity, and body mass index (BMI). Results: The aquatic exercise program had trivial and small effects on physical fitness, large effects on pain, and moderate effects on depression. The mediation model confirmed the indirect effect of pain on the decrease of depression in the participants of the aquatic exercise program. Conclusions: Participants with RA in the aquatic exercise program experienced improvements in physical fitness, depression, and joint pain. Moreover, the improvements in joint pain mediated improvements in depression

Glucose Levels as a Mediator of the Detrimental E ect of Abdominal Obesity on Relative Handgrip Strength in Older Adults

Excess central adiposity accelerates the decline of muscle strength in older people. Additionally, hyperglycemia, independent of associated comorbidities, is related to the loss of muscle mass and strength, and contributes to functional impairment in older adults. We studied the mediation e ect of glucose levels, in the relationship between abdominal obesity and relative handgrip strength (HGS). A total of 1571 participants (60.0% women, mean age 69.1 7.0 years) from 86 municipalities were selected following a multistage area probability sampling design. Measurements included demographic and anthropometric/adiposity markers (weight, height, body mass index, and waist circumference). HGS was measured using a digital dynamometer for three sets and the mean value was recorded. The values were normalized to body weight (relative HGS). Fasting glucose was analyzed by enzymatic colorimetric methods. Mediation analyses were performed to identify associations between the independent variable (abdominal obesity) and outcomes (relative HGS), as well as to determine whether fasting glucose levels mediated the relationship between excess adiposity and relative HGS. A total of 1239 (78.8%) had abdominal obesity. Abdominal obesity had a negative e ect on fasting glucose ( ß = 9.04, 95% CI = 5.87 to 12.21); while fasting glucose to relative HGS was inversely related ( ß = -0.003, 95% CI = -0.005 to -0.001), p < 0.001. The direct e ect of abdominal obesity on relative HGS was statistically significant ( ß = -0.069, 95% CI = -0.082 to -0.057), p < 0.001. Lastly, fasting glucose levels mediates the detrimental e ect of abdominal obesity on relative HGS (indirect effect = -0.002, 95% CI = -0.004 to -0.001), p < 0.001. Our results suggest that the glucose level could worsen the association between abdominal obesity status and lower HGS. Thus, it is plausible to consider fasting glucose levels when assessing older adults with excess adiposity and/or suspected loss of muscle mass

The validity and reliability of a novel mobile app to measure agility performance in the physically active youth population

Agility is a key component of physical fitness in adolescents. However, the measurement of this variable is usually complex, requiring high cost instruments and complex software. To test the validity and reliabilityof a novel iPhone app (Lap Tracker Auto-timer) to measure agility performance among adolescents.Twenty-four physically active adolescents (15.7 ± 2.3 years old) participated in two testing sessions (separated by 7 days). They performed three 4 x 10 m agility test trials measured by Photocell or the iPhone app.The correlation analysis revealed high validity (r = .92; 95% confidence interval [CI] = .88 –.95), with a standard error of the estimate of 0.56 s (p < 0.001). The coefficient of variation (CV; 0.09) and intraclass correlation coefficient (ICC; .93; 95% CI = .85 –.97) showed an acceptable reliability.This study demonstrated that the iPhone App Lap Tracker Auto-timer could be a valid, reliable and low-cost tool to evaluate agility performance in adolescents. However, more studies are required to guarantee the utility of this app

Role for physical fitness in the association between age and cognitive function in older adults: a mediation analysis of the SABE colombia study

Objectives. We investigated the association between physical fitness and cognitive status. Further, we examined whether physical fitness mediates the association between cognitive functioning and aging. Design. Cross-sectional study. Setting. Urban and rural Colombian older adults. Methods. 4416 participants from the SABE study were included in the current analysis. Physical fitness was assessed with the handgrip test and the usual gait speed test. Cognitive status was evaluated through the Folstein Mini-Mental State Examination. A parallel mediation path was used to test the possible mediator role of physical fitness between aging and cognitive functioning. Results. Older adults with lower handgrip strength (HGS) were more likely to have mild-cognitive status than older adults with healthy HGS (OR = 1.53, 95% CI = 1.15; 2.02). In addition, older adults with a slower gait speed were more likely to have mild cognitive impairment (OR = 2.05, 95% CI = 1.54; 2.78). Age had an inverse relationship with cognitive function (β = -0.110, 95% CI = -0.130; -0.100) and it was also inversely associated with HGS (β = -0.003, 95% CI = -0.005; -0.002) and gait speed (β = -0.010, 95% CI = -0.011; -0.009). The indirect effects, which indicate that the effect of age on cognitive function is transmitted through mediators, showed that both gait speed (β = -0.028, 95% CI = -0.036; -0.020) and HGS (β = -0.014, 95% CI = -0.024; -0.005) were independent mediators of the detrimental effect of aging on cognitive function. Conclusions. Physical fitness mediates the effects of aging on cognitive functioning. Our findings suggest that physical activity can be a key factor to prevent cognitive deterioration during aging process.The study was funded by the Ministry of Health and Social Protection of Colombia Colciencias contract No. 764 of 2013. Robinson Ramírez-Vélez training grant (ID420) as a postdoctoral research fellow with the Universidad Pública de Navarra (UPNA)

Gait speed as a mediator of the effect of sarcopenia on dependency in activities of daily living

Background Sarcopenia in older adults is strongly associated with an increase in dependency in activities of daily living (ADL) and with a decline in gait speed. Interestingly, gait speed has been shown to independently predict mortality. In this context, our study aimed to explore the mediator role of gait speed on the relationship between sarcopenia and dependency in ADL. Methods A cross-sectional study was conducted in Colombia, 19 705 older adults with a mean age of 70 years, 55.6% women, 16.1% with sarcopenia, and 14.7% mild, moderate, or severe dependency in ADL, according to ‘SABE Survey 2015’. Sarcopenia was assessed by calf circumference and ADL dependence through the Barthel Index. Gait speed was measured over a distance of 3 m. The association between sarcopenia condition and gait speed and dependency level was analysed by linear regression adjusted by covariates. To examine whether gait speed mediated the association between sarcopenia and dependence components of physical function, simple mediation models were generated using ordinary least squares with the macro PROCESS version 3.2, adjusted for age, sex, and body mass index (BMI). Results Significant differences (P < 0.05) were found in gait speed and dependency in ADL between the sarcopenia and nonsarcopenia groups after adjusting for age, sex, and BMI. BMI was significantly higher in the non-sarcopenia group whereas dependency was significantly higher in the sarcopenia group (19.6% vs. 13.8%). Results from mediation model regression analysis indicated a significant and direct detrimental effect of sarcopenia on dependency in ADL (β = 0.05; P < 0.001), and a significant indirect effect of gait speed on the direct effect ( 0.009 to 0.004). Conclusions The negative effect of sarcopenia on functional dependence was mediated by the gait speed. Therefore, gait speed may positively influence the detrimental effect of sarcopenia for dependency, after adjusting for age, gender, and BMI. Consequently, physical exercise should be promoted and focused to circumvent the gait speed decline associated with age in older people with sarcopenia

Fitness, physical functionality and quality of life in elderly: a mediation analysis

El estudio tiene como objetivo analizar la relación entre la condición física y la calidad de vida relacionada con la salud (CVRS), midiendo el efecto mediador de la funcionalidad física. Se realizaron diferentes pruebas de condición física a adultos mayores. El cuestionario composite physical function se utilizó para medir la funcionalidad física y el EQ-5D-5L para valorar la CVRS. El análisis de mediación confirma el papel de mediador de la funcionalidad física entre la condición física y la CVRS (B = .051; CI = .036 a .067). La asociación directa de la condición física y CVRS tuvo un efecto B = .0314, t = 3.313. p = .001. Se concluye que la relación entre la condición física y la CVRS está parcialmente mediada por la función física en mayores.The aim of this work was to analyze the association between fitness and health related quality of life, assessing the physical functionality impact as a mediator. Different tests of physical condition were carried. The composite physical function (CPF) questionnaire was used to measure the physical functionality and the EQ-5D-5L to quantify the HRQoL. The mediation analysis confirms the physical functionality mediator role between fitness and HRQoL (B=.051; CI= .036 to .067). The direct association of fitness and HRQoL had an effect of B=.0314, t=3.313. p=.001. It is concluded that the fitness, regardless its impact on physical functioning, is related to HRQoL

Glucose levels as a mediator of the detrimental effect of abdominal obesity on relative handgrip strength in older adults

Excess central adiposity accelerates the decline of muscle strength in older people. Additionally, hyperglycemia, independent of associated comorbidities, is related to the loss of muscle mass and strength, and contributes to functional impairment in older adults. We studied the mediation effect of glucose levels, in the relationship between abdominal obesity and relative handgrip strength (HGS). A total of 1571 participants (60.0% women, mean age 69.1 ± 7.0 years) from 86 municipalities were selected following a multistage area probability sampling design. Measurements included demographic and anthropometric/adiposity markers (weight, height, body mass index, and waist circumference). HGS was measured using a digital dynamometer for three sets and the mean value was recorded. The values were normalized to body weight (relative HGS). Fasting glucose was analyzed by enzymatic colorimetric methods. Mediation analyses were performed to identify associations between the independent variable (abdominal obesity) and outcomes (relative HGS), as well as to determine whether fasting glucose levels mediated the relationship between excess adiposity and relative HGS. A total of 1239 (78.8%) had abdominal obesity. Abdominal obesity had a negative effect on fasting glucose (β = 9.04, 95%CI = 5.87 to 12.21); while fasting glucose to relative HGS was inversely related (β = −0.003, 95%CI = −0.005 to −0.001), p < 0.001. The direct effect of abdominal obesity on relative HGS was statistically significant (β = −0.069, 95%CI = −0.082 to −0.057), p < 0.001. Lastly, fasting glucose levels mediates the detrimental effect of abdominal obesity on relative HGS (indirect effect β = −0.002, 95%CI = −0.004 to −0.001), p < 0.001. Our results suggest that the glucose level could worsen the association between abdominal obesity status and lower HGS. Thus, it is plausible to consider fasting glucose levels when assessing older adults with excess adiposity and/or suspected loss of muscle mass

Validation of surrogate anthropometric indices in older adults: what is the best indicator of high cardiometabolic risk factor clustering?

Incluye correccionesThe present study evaluated the ability of five obesity-related parameters, including a body shape index (ABSI), conicity index (CI), body roundness index (BRI), body mass index (BMI), and waist-to-height ratio (WtHR) for predicting increased cardiometabolic risk in a population of elderly Colombians. A cross-sectional study was conducted on 1502 participants (60.3% women, mean age 70 ± 7.6 years) and subjects’ weight, height, waist circumference, serum lipid indices, blood pressure, and fasting plasma glucose were measured. A cardiometabolic risk index (CMRI) was calculated using the participants’ systolic and diastolic blood pressure, triglycerides, high-density lipoprotein and fasting glucose levels, and waist circumference. Following the International Diabetes Federation definition, metabolic syndrome was defined as having three or more metabolic abnormalities. All surrogate anthropometric indices correlated significantly with CMRI (p < 0.01). Receiver operating characteristic curve analysis of how well the anthropometric indices identified high cardiometabolic risk showed that WtHR and BRI were the most accurate indices. The best WtHR and BRI cut-off points in men were 0.56 (area under curve, AUC 0.77) and 4.71 (AUC 0.77), respectively. For women, the WtHR and BRI cut-off points were 0.63 (AUC 0.77) and 6.20 (AUC 0.77), respectively. In conclusion, BRI and WtHR have a moderate discriminating power for detecting high cardiometabolic risk in older Colombian adults, supporting the idea that both anthropometric indices are useful screening tools for use in the elderly

Does trapped O2 form in the bulk of LiNiO2 during charging?

LiNiO2 remains a critical archetypal material for high energy density Li-ion batteries, forming the basis of Ni-rich cathodes in use today. Nevertheless, there are still uncertainties surrounding the charging mechanism at high states of charge and the potential role of oxygen redox. We show that oxidation of O2− across the 4.2 V vs. Li+/Li plateau forms O2 trapped in the particles and is accompanied by the formation of 8% Ni vacancies on the transition metal sites of previously fully dense transition metal layers. Such Ni vacancy formation on charging activates O-redox by generating non-bonding O 2p orbitals and is necessary to form vacancy clusters to accommodate O2 in the particles. Ni accumulates at and near the surface of the particles on charging, forming a Ni-rich shell approximately 5 nm thick; enhanced by loss of O2 from the surface, the resulting shell composition is Ni2.3+1.75O2. The overall Ni oxidation state of the particles measured by XAS in fluorescence yield mode after charging across the plateau to 4.3 V vs. Li+/Li is approximately +3.8; however, taking account of the shell thickness and the shell Ni oxidation state of +2.3, this indicates a Ni oxidation state in the core closer to +4 for compositions beyond the plateau

A contemporary picture of enterococcal endocarditis

BACKGROUND: Enterococcal endocarditis (EE) is a growing entity in Western countries. However, quality data from large studies is lacking. OBJECTIVES: The purpose of this study was to describe the characteristics and analyze the prognostic factors of EE in the GAMES cohort. METHODS: This was a post hoc analysis of a prospectively collected cohort of patients from 35 Spanish centers from 2008 to 2016. Characteristics and outcomes of 516 cases of EE were compared with those of 3,308 cases of nonenterococcal endocarditis (NEE). Logistic regression and Cox proportional hazards regression analysis were performed to investigate risk factors for in-hospital and 1-year mortality, as well as relapses. RESULTS: Patients with EE were significantly older; more frequently presented chronic lung disease, chronic heart failure, prior endocarditis, and degenerative valve disease; and had higher median age-adjusted Charlson score. EE more frequently involved the aortic valve and prosthesis (64.3% vs. 46.7%; p < 0.001; and 35.9% vs. 28.9%; p = 0.002, respectively) but less frequently pacemakers/defibrillators (1.5% vs. 10.5%; p < 0.001), and showed higher rates of acute heart failure (45% vs. 38.3%; p = 0.005). Cardiac surgery was less frequently performed in EE (40.7% vs. 45.9%; p = 0.024). No differences in in-hospital and 1-year mortality were found, whereas relapses were significantly higher in EE (3.5% vs. 1.7%; p = 0.035). Increasing Charlson score, LogEuroSCORE, acute heart failure, septic shock, and paravalvular complications were risk factors for mortality, whereas prior endocarditis was protective and persistent bacteremia constituted the sole risk factor for relapse. CONCLUSIONS: Besides other baseline and clinical differences, EE more frequently affects prosthetic valves and less frequently pacemakers/defibrillators. EE presents higher rates of relapse than NEE. Copyright © 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. KEYWORDS: enterococci; epidemiology; heart failure; infective endocarditis; prosthetic valves; relapse