Evaluation of a resistance training program for adults with or at risk of developing diabetes: an effectiveness study in a community setting

Background: To examine the effects of a community-based resistance training program (Lift for Life) on waist circumference and functional measures in adults with or at risk of developing type 2 diabetes.Methods: Lift for Life is a research-to-practice initiative designed to disseminate an evidence-based resistance training program for adults with or at risk of developing type 2 diabetes to existing health and fitness facilities in the Australian community. A retrospective assessment was undertaken on 86 participants who had accessed the program within 4 active providers in Melbourne, Australia. The primary goal of this longitudinal study was to assess the effectiveness of a community-based resistance training program, thereby precluding a randomized, controlled study design. Waist circumference, lower body (chair sit-to-stand) and upper body (arm curl test) strength, and agility (timed up-and-go) measures were collected at baseline and repeated at 2 months (n = 86) and again at 6 months (n = 32).Results: Relative to baseline, there was a significant decrease in mean waist circumference (-1.9 cm, 95% CI: -2.8 to -1.0) and the timed agility test (-0.8 secs, 95% CI: -1.0 to -0.6); and significant increases in lower body (number of repetitions: 2.2, 95% CI: 1.4-3.0) and upper body (number of repetitions: 3.8, 95% CI: 3.0-4.6) strength at the completion of 8 weeks. Significant differences remained at the 16 week assessment. Pooled time series regression analyses adjusted for age and sex in the 32 participants who had complete measures at baseline and 24-week follow-up revealed significant time effects for waist circumference and functional measures, with the greatest change from baseline observed at the 24-week assessment.Conclusions: These findings indicate that an evidence-based resistance training program administered in the community setting for those with or at risk of developing type 2 diabetes, can lead to favorable health benefits, including reductions in central obesity and improved physical function

Predicting In-Hospital Mortality in Patients Undergoing Percutaneous Coronary Intervention

Background Standardization of risk is critical in benchmarking and quality improvement efforts for percutaneous coronary interventions (PCI). In 2018, the CathPCI Registry was updated to include additional variables to better classify higher-risk patients. Objectives We sought to develop a model for predicting in-hospital mortality risk following PCI incorporating these additional variables. Methods Data from 706,263 PCIs performed between 7/2018-6/2019 at 1,608 sites were used to develop and validate a new full and pre-catheterization model to predict in-hospital mortality, and a simplified bedside risk score. The sample was randomly split into a development (70%, n=495,005) and validation cohort (30%, n=211,258). We created 1,000 bootstrapped samples of the development cohort and used stepwise selection logistic regression on each sample. The final model included variables that were selected in at least 70% of the bootstrapped samples and those identified a priori due to clinical relevance. Results In-hospital mortality following PCI varied based on clinical presentation. Procedural urgency, cardiovascular instability, and level of consciousness after cardiac arrest were most predictive of in-hospital mortality. The full model performed well, with excellent discrimination (c-index: 0.943) in the validation cohort and good calibration across different clinical and procedural risk cohorts. The median hospital risk-standardized mortality rate was 1.9% and ranged from 1.1% to 3.3% (interquartile range: 1.7%-2.1%). Conclusions The risk of mortality following PCI can be predicted in contemporary practice by incorporating variables that reflect clinical acuity. This model, which includes data previously not captured, is a valid instrument for risk stratification and for quality improvement efforts

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.Peer reviewe

Diabetes prevalence and determinants in Indigenous Australian populations: A systematic review

Aims: To perform a systematic review of the prevalence of diabetes and impaired glucose tolerance (IGT) in Indigenous Australians in order to clarify overall patterns, by determinants such as age, gender, region, ethnicity and remoteness. Methods: The OVID interface to Medline and the Australian Indigenous Health. InfoNet databases were systematically searched from years 1997 to 2010. Studies reporting diabetes prevalence were included if they used population-based samples of Indigenous Australians. Diagnosis of diabetes was based on self-report or standard diagnostic criteria. Results: Twenty-four studies were included. The diabetes prevalence ranged from 3.5 to 33.1%; IGT estimates ranged from 4.7 to 21.1%. Prevalence was greater among Indigenous Australian women compared to men, the Northern Territory's Top End compared to Central Australia, Torres Strait Islanders compared to Aboriginals, older (≥35 years) compared to younger

Classroom standing desks and sedentary behavior: a systematic review

CONTEXT: Reducing sedentary behaviors, or time spent sitting, is an important target for health promotion in children. Standing desks in schools may be a feasible, modifiable, and acceptable environmental strategy to this end. OBJECTIVE: To examine the impact of school-based standing desk interventions on sedentary behavior and physical activity, health-related outcomes, and academic and behavioral outcomes in school-aged children. DATA SOURCES: Ovid Embase, Medline, PsycINFO, Web of Science, Global Health, and CINAHL. STUDY SELECTION: Full-text peer-reviewed journal publications written in English; samples of school-aged youth (5-18 years of age); study designs including the same participants at baseline and follow-up; and use of a standing desk as a component of the intervention. DATA EXTRACTION: Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS: Eight studies satisfied selection criteria and used quasi-experimental (n = 4), randomized controlled trial (n = 3), and pre-post, no control (n = 1) designs. When examined, time spent standing increased in all studies (effect sizes: 0.38-0.71), while sitting time decreased from a range of 59 to 64 minutes (effect sizes: 0.27-0.49). Some studies reported increased physical activity and energy expenditure and improved classroom behavior. LIMITATIONS: One-half of the studies had nonrandomized designs, and most were pilot or feasibility studies. CONCLUSIONS: This initial evidence supports integrating standing desks into the classroom environment; this strategy has the potential to reduce sitting time and increase standing time among elementary schoolchildren. Additional research is needed to determine the impact of standing desks on academic performance and precursors of chronic disease risk

Associations of strength training with impaired glucose metabolism: The AusDiab Study

Purpose: To examine the association of strength training (ST) activity with impaired glucose metabolism (IGM) in Australian adults. Methods: On the basis of an oral glucose tolerance test, IGM (which includes impaired fasting glucose, impaired glucose tolerance, or newly diagnosed type 2 diabetes), was assessed in 5831 adults (mean age = 56.0 ± 12.7 yr) without clinically diagnosed diabetes who participated in the 2004–2005 Australian Diabetes, Obesity and Lifestyle Study (AusDiab). Meeting the current ST guideline was based on reporting ST at least two times per week (frequency) or ≥40 min·wk−1 in total (duration). Multiple logistic regression analyses examined associations of self-reported ST frequency and duration with IGM. Results: After adjustment for known confounding factors and total moderate- to vigorous-intensity leisure time exercise, the odds ratio (OR) of IGM was 0.73 (95% confidence interval [CI] = 0.59–0.91, P ≤ 0.005) in those who met the ST frequency guideline (two or more times per week) and 0.69 (95% CI = 0.55–0.87, P ≤ 0.01) in those who met the ST duration guideline (≥40 min·wk−1). Those who achieved both the recommended frequency and duration of ST had 24% lower odds of IGM. There was also evidence that a moderate frequency (once a week) and duration (10–39 min·wk−1) of ST reduced the odds of IGM (OR frequency = 0.53, 95% CI = 0.51–0.81, P ≤ 0.01; OR duration = 0.72, 95% CI = 0.52–1.00, P ≤ 0.05). Conclusions: These findings support the importance of including ST activity, at a frequency of at least once per week, within exercise management recommendations for the maintenance of favorable metabolic health, particularly as it may contribute to reducing the risk of developing type 2 diabetes mellitus