The relationship between physical activity and quality of life during the confinement induced by COVID-19 outbreak: a pilot study in Tunisia

The present study aimed to determine the relationship between physical activity (PA) and quality of life (QoL) during the confinement caused by the COVID-19 outbreak. 216 participants (men: n = 112, women: n= 114) were included in the present study. They were divided into three groups (i.e., inactive group [IG]: less than 600 Metabolic Equivalent of Tasks (METs), n = 131; minimally active group [MAG]: from 600 to 2999 METs, n = 49; and health-enhancing PA group [HEPAG]: 3000 + METs, n = 36) based on their habitual PA level in the period of confinement. World Health Organization Quality of Life Instrument-Short Form (WHOQOL-Bref) and International Physical Activity Questionnaire-Bref (IPAQ-Bref) questionnaires were used to assess QoL and PA intensities. The main findings of the present study showed that MAG and HEPAG have better total PA, physical, psychological, social, and environmental QoL domains scores than IG (all, p<0.01). Small to large correlations (r ranging 0.14-0.72) were also observed between total PA, total walking activity, total moderate-intensity PA, total vigorous-intensity PA and QoL domains (all, p<0.01). PA with light- moderate- and vigorous intensities can be well recommended to decrease the negative psychosocial effect of confinement. However longitudinal studies are needed to draw causal inferences and underpin more robust and evidence-based and informed recommendations

Liposomes for Intra-Articular Analgesic Drug Delivery in Orthopedics: State-of-Art and Future Perspectives. Insights from a Systematic Mini-Review of the Literature.

Background and objectives: Liposomal structures are artificial vesicles composed of one or several lamellae of phospholipids which surround an inner aqueous core. Given the amphoteric nature of phospholipids, liposomes are promising systems for drug delivery. The present review provides an updated synthesis of the main techniques for the production of liposomes for orthopedic applications, focusing on the drawbacks of the conventional methods and on the advantages of high pressure techniques. Materials and Methods: Articles published in any language were systematically retrieved from two major electronic scholarly databases (PubMed/MEDLINE and Scopus) up to March 2020. Nine articles were retained based on the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" (PRISMA) guidelines. Results: Liposome vesicles decrease the rate of inflammatory reactions after local injections, and significantly enhance the clinical effectiveness of anti-inflammatory agents providing controlled drug release, reducing toxic side effects. Conclusions: This review presents an update on the improvement in musculoskeletal ailments using liposome treatment

The Relationship between Cognitive Function, Lifestyle Behaviours and Perception of Stress during the COVID-19 Induced Confinement: Insights from Correlational and Mediation Analyses

Background: Home confinement during the COVID-19 outbreak may affect lifestyle behaviours, such as daily physical activity, social relationships, eating behaviours, and sleep, among others, which in turn may compromise mental health and psychological states. The aim of the present study was to determine the effects of COVID-19-induced home confinement on stress, attention, and lifestyle behaviours and the correlations between them. Methods: Participants included 144 students (aged 18–22 years, 62.5% female, 89.5% single). Stress, attention, and lifestyle behaviours were assessed using the Perceived Stress Scale (PSS), d2 test, and the Simple Lifestyle Indicator Questionnaire adapted and modified (SLIQ), respectively. Total PSS score, concentration performance (CP), errors (E), and lifestyle behaviours (e.g., diet, exercise/activity, alcohol, and smoking) before and during confinement were calculated. Results: The data showed a significant difference between before and during confinement in total PSS, CP, E, and all lifestyle behaviours (all, p < 0.05). Significant correlations existed between total PSS score, CP, E, and lifestyle behaviours (r= −87–98, all, p < 0.05). Conclusions: Home confinement has a negative effect on stress, attention, and lifestyle behaviours. This study suggests that the adoption of proper lifestyle behaviours, particularly diet, disciplined hygiene, and physical activity, boost health, psychological states, and cognitive function during COVID-19-induced confinement

Effect of Taekwondo Practice on Cognitive Function in Adolescents with Attention Deficit Hyperactivity Disorder.

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neuro-developmental/behavioral disorders among adolescents. Sport and physical activity seem to play a major role in the development of cognition, memory, selective attention and motor reaction time, especially among adolescents with ADHD. In this context, the objective of this study was to investigate the effects of a one-and-a-half-year-long Taekwondo (TKD) intervention on cognitive function in adolescents with ADHD. Two cognitive instruments, namely the Stroop and the Ruff 2 and 7 tests, were administered to assess attentional inhibitory control and sustained and selective visual attention, respectively. Comparisons between the TKD and control groups at baseline did not reveal significant differences. For post-test scores, there were statistically significant differences on the Stroop color block test (large effect size or ES = 1.26 [95% confidence interval or CI 0.30⁻2.22]), the color-word interference test (large ES = 2.16 [95% CI 1.10⁻3.26]), the interference test (large ES = 1.63 [95% CI 0.62⁻2.64]) and error (large ES = -2.20 [95% CI -3.31 to -1.10]). Similar trends were reported for the Ruff 2 and 7 automated detection trials (large ES = 2.78 [95% CI 1.55⁻4.01]), controlled search trials (large ES = 2.56 [95% CI 1.38⁻3.75]) and total speed (large ES = -2.90 [95% CI -4.15 to -1.64]). In conclusion, TKD practice increased selective attention in adolescents with ADHD. Practitioners should implement martial art programs in their general plans to favorably influence attention and health in adolescents with ADHD

The Effect of Mental Fatigue on Cognitive and Aerobic Performance in Adolescent Active Endurance Athletes: Insights from a Randomized Counterbalanced, Cross-Over Trial

The aim of this randomized counterbalanced, 2 × 2 cross-over study was to investigate the effects of mental fatigue on cognitive and aerobic performance in adolescent active endurance athletes. Ten active male endurance athletes (age = 16 ± 1.05 years, height = 1.62 ± 0.54 m, body mass = 55.5 ± 4.2 kg) were familiarized to all experimental procedures on day 1. On days 2 and 3, participants provided a rating of mental fatigue before and after completing a 30 min Stroop test that measures selective attention capacity and skills and their processing speed ability (mentally fatigued condition), or a 30 min control condition in a randomized counterbalanced order. They then performed d2 test and a 20 m multistage fitness test (MSFT), which was used to measure selective and sustained attention and visual scanning speed (i.e., concentration performance (CP) and total number of errors (E)) and aerobic fitness (i.e., maximum oxygen uptake (VO2max) and velocity at which VO2max occurs (vVO2max)), respectively. Rating of perceived exertion (RPE) was assessed after a MSFT. Subjective ratings of mental fatigue were higher after the Stroop task (p < 0.001). CP (p = 0.0.1), E (p < 0.001), vVO2max (p = 0.020), and estimated VO2max (p = 0.021) values were negatively affected by mental fatigue. RPE were significantly higher in the mentally fatigued than in the control conditions (p = 0.02) post-MSFT. Mental fatigue impairs aerobic and cognitive performance in active male endurance athletes

COVID-19 Vasculitis and vasculopathy-Distinct immunopathology emerging from the close juxtaposition of Type II Pneumocytes and Pulmonary Endothelial Cells

The SARS-CoV-2 virus ACE-2 receptor utilization for cellular entry and the defined ACE-2 receptor role in cardiovascular medicine hinted at dysregulated endothelial function or even direct viral endotheliitis as the key driver of severe COVID-19 vascular immunopathology including reports of vasculitis. In this article, we critically review COVID-19 immunopathology from the vasculitis perspective and highlight the non-infectious nature of vascular endothelial involvement in severe COVID-19. Whilst COVID-19 lung disease pathological changes included juxta-capillary and vascular macrophage and lymphocytic infiltration typical of vasculitis, we review the evidence reflecting that such “vasculitis” reflects an extension of pneumonic inflammatory pathology to encompass these thin-walled vessels. Definitive, extrapulmonary clinically discernible vasculitis including cutaneous and cardiac vasculitis also emerged- namely a dysregulated interferon expression or “COVID toes” and an ill-defined systemic Kawasaki-like disease. These two latter genuine vasculitis pathologies were not associated with severe COVID-19 pneumonia. This was distinct from cutaneous vasculitis in severe COVID-19 that demonstrated pauci-immune infiltrates and prominent immunothrombosis that appears to represent a novel immunothrombotic vasculitis mimic contributed to by RNAaemia or potentially diffuse pulmonary venous tree thrombosis with systemic embolization with small arteriolar territory occlusion, although the latter remains unproven. Herein, we also performed a systematic literature review of COVID-19 vasculitis and reports of post-SARS-CoV-2 vaccination related vasculitis with respect to the commonly classified pre-COVID vasculitis groupings. Across the vasculitis spectrum, we noted that Goodpasture’s syndrome was rarely linked to natural SARS-CoV-2 infection but not vaccines. Both the genuine vasculitis in the COVID-19 era and the proposed vasculitis mimic should advance the understanding of both pulmonary and systemic vascular immunopathology

Discrepancies Between Classic and Digital Epidemiology in Searching for the Mayaro Virus: Preliminary Qualitative and Quantitative Analysis of Google Trends

Background: Mayaro virus (MAYV), first discovered in Trinidad in 1954, is spread by the Haemagogus mosquito. Small outbreaks have been described in the past in the Amazon jungles of Brazil and other parts of South America. Recently, a case was reported in rural Haiti. Objective: Given the emerging importance of MAYV, we aimed to explore the feasibility of exploiting a Web-based tool for monitoring and tracking MAYV cases. Methods: Google Trends is an online tracking system. A Google-based approach is particularly useful to monitor especially infectious diseases epidemics. We searched Google Trends from its inception (from January 2004 through to May 2017) for MAYV-related Web searches worldwide. Results: We noted a burst in search volumes in the period from July 2016 (relative search volume [RSV]=13%) to December 2016 (RSV=18%), with a peak in September 2016 (RSV=100%). Before this burst, the average search activity related to MAYV was very low (median 1%). MAYV-related queries were concentrated in the Caribbean. Scientific interest from the research community and media coverage affected digital seeking behavior. Conclusions: MAYV has always circulated in South America. Its recent appearance in the Caribbean has been a source of concern, which resulted in a burst of Internet queries. While Google Trends cannot be used to perform real-time epidemiological surveillance of MAYV, it can be exploited to capture the public’s reaction to outbreaks. Public health workers should be aware of this, in that information and communication technologies could be used to communicate with users, reassure them about their concerns, and to empower them in making decisions affecting their health

Development and preliminary data on the use of a mobile app specifically designed to increase community awareness of invasive pneumococcal disease and its prevention

PublishedGiven the growing use and great potential of mobile apps, this project aimed to develop and implement a user-friendly app to increase laypeople's knowledge and awareness of invasive pneumococcal disease (IPD). Despite the heavy burden of IPD, the documented low awareness of IPD among both laypeople and healthcare professionals and far from optimal pneumococcal vaccination coverage, no app specifically targeting IPD has been developed so far. The app was designed to be maximally functional and conceived in accordance with user-centered design. Its content, layout and usability were discussed and formally tested during several workshops that involved the principal stakeholders, including experts in IPD and information technology and potential end-users. Following several workshops, it was decided that, in order to make the app more interactive, its core should be a personal “checker” of the risk of contracting IPD and a user-friendly risk-communication strategy. The checker was populated with risk factors identified through both Italian and international official guidelines. Formal evaluation of the app revealed its good readability and usability properties. A sister web site with the same content was created to achieve higher population exposure. Seven months after being launched in a price- and registration-free modality, the app, named “Pneumo Rischio,” averaged 20.9 new users/day and 1.3 sessions/user. The first in-field results suggest that “Pneumo Rischio” is a promising tool for increasing the population's awareness of IPD and its prevention through a user-friendly risk checker.The development of the app is a part of the project on increasing the population's awareness of invasive pneumococcal disease and has been supported by sponsorship from Pfizer S.r.l. The sponsor had no role in the app design and development. The authors thank Progetti di Impresa Srl for creating the app and website

Systemic Sclerosis is Linked to Psoriasis and May Impact on Patients' Survival: A Large Cohort Study.

Although skin manifestations are quite common in systemic sclerosis (SSc), a link between SSc and psoriasis (PsO) has been poorly investigated. We assessed the Clalit medical database in a cohort study to compare the prevalence of PsO between SSc-patients and SSc-free controls. We also evaluated the SSc-related autoantibodies' role in the co-existence of the two conditions. Survival analysis was performed using both univariate (Kaplan-Meier, log-rank test) and multivariate (Cox proportional-hazards technique) analyses. Our cohort of 2,431 SSc-patients was age- and gender-matched with 12,710 controls (case-control match 1:5.2). There were 150 (1.2%) cases of PsO among controls and 47 (1.9%) among SSc-patients (p = 0.0027). A SSc diagnosis was an independent risk factor for PsO with an odds ratio (OR) of 2.16 (95%CI 1.38-3.39, p = 0.0008). Among SSc-patients, 98.6% with PsO were antinuclear antibodies (ANA)-negative. In terms of survival, the mortality rate in SSc-patients with PsO was lower than SSc without PsO (14.9% vs. 26%, p < 0.0001). At the multivariate-analysis, SSc-patients with PsO compared to SSc-patients without PsO had an OR for death of 0.44 (95%CI 0.19-0.99, p < 0.05). SSc is independently associated with PsO. The cases with concurrent PsO and SSc are almost exclusively ANA-negative and may exhibit a better survival

The Impact of Intermittent Fasting (Ramadan Fasting) on Psoriatic Arthritis Disease Activity, Enthesitis, and Dactylitis: A Multicentre Study

Intermittent circadian fasting, namely Ramadan, is a common worldwide practice. Such fasting has a positive impact on psoriasis, but no data exist on its role in psoriatic arthritis (PsA)—a disease that is clearly linked to body mass index. We enrolled 37 patients (23 females and 14 males) with a mean age 43.32 ± 7.81 and they fasted for 17 h for one month in 2016. The baseline PsA characteristics were collected and 12 (32.4%) patients had peripheral arthritis, 13 (35.1%) had axial involvement, 24 (64.9%) had enthesitis, and 13 (35.1%) had dactylitis. Three patients (8.1%) were treated with methotrexate, 28 (75.7%) with TNF-α blockers, and 6 (16.2%) with IL-17 blockers. After a month of intermittent fasting, C-reactive protein (CRP) levels decreased from 14.08 ± 4.65 to 12.16 ± 4.46 (p < 0.0001), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) decreased from 2.83 ± 1.03 to 2.08 ± 0.67 (p = 0.0078), Psoriasis Area Severity Index (PASI) decreased from 7.46 ± 2.43 to 5.86 ± 2.37 (p < 0.0001), and Disease Activity index for PSoriatic Arthritis (DAPSA) decreased from 28.11 ± 4.51 to 25.76 ± 4.48 (p < 0.0001). Similarly, enthesitis improved after fasting, with Leeds Enthesitis Index (LEI) decreasing from 2.25 ± 1.11 to 1.71 ± 0.86 (p < 0.0001) and dactylitis severity score (DSS) decreasing from 9.92 ± 2.93 to 8.54 ± 2.79 (p = 0.0001). Fasting was found to be a predictor of a decrease in PsA disease activity scores (DAPSA, BASDAI, LEI, DSS) even after adjustment for weight loss. IL-17 therapy was found to be an independent predictor of decreases in LEI after fasting. These preliminary data may support the use of chronomedicine in the context of rheumatic diseases, namely PsA. Further studies are needed to support our findings